TY - JOUR
T1 - Prognostic value of cardiac troponin i measured with a highly sensitive assay in patients with stable coronary artery disease
AU - Omland, Torbjørn
AU - Pfeffer, Marc A.
AU - Solomon, Scott D.
AU - de Lemos, James A
AU - Røsjø, Helge
AU - Benth, Jurate Šaltyte
AU - Maggioni, Aldo
AU - Domanski, Michael J.
AU - Rouleau, Jean L.
AU - Sabatine, Marc S.
AU - Braunwald, Eugene
N1 - Funding Information:
The PEACE trial was sponsored by the National Heart, Lung, and Blood Institute with support from Knoll Pharmaceuticals and Abbott Laboratories. This biomarker substudy was supported by Abbott Diagnostics and Roche Diagnostics. Dr. Omland has received speaker's honoraria from Abbott Diagnostics, Siemens Healthcare Diagnostics, and Roche Diagnostics; and research grant support from Abbott Diagnostics and Roche Diagnostics through Akershus University Hospital. Dr. Pfeffer has received consulting fees from Amgen, Anthera, AstraZeneca, Biogen, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb, Cytokinetics, Daiichi-Sankyo, Genzyme, Gilead, GlaxoSmithKline, Medtronic, Nicox, Novartis, Roche, Salutria, Sanofi-Aventis, Servier, the University of Oxford, and VIA Pharmaceutics; and research grant support from Abbott , Amgen , Baxter , Celladon , Novartis , and Sanofi-Aventis . Brigham and Women's Hospital has been awarded patents regarding the use of inhibition of the renin-angiotensin system in selected survivors of myocardial infarction; Dr. Pfeffer is among the coinventors. The licensing agreement with Abbott, Boehringer Ingelheim, and Novartis is not linked to sales. Dr. de Lemos has received research grant support from Abbott Diagnostics and Roche Diagnostics . Dr. Sabatine has received research grant support from Abbott Laboratories , BRAHMS , Critical Diagnostics , and Roche Diagnostics through Brigham and Women's Hospital. Dr. Braunwald has received grant support from Knoll Pharmaceuticals and Abbott Laboratories (as a supplement to the PEACE trial). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
PY - 2013/3/26
Y1 - 2013/3/26
N2 - Objectives: The aims of this study were to assess the prognostic value of cardiac troponin I levels, measured with a new high-sensitivity assay, in low-risk patients with stable coronary artery disease (CAD) and to contrast its determinants and prognostic merit with that of high-sensitivity cardiac troponin T (hs-TnT). Background: New, highly sensitive cardiac troponin assays permit evaluation of the association between troponin levels and outcomes in patients with stable CAD. Methods: High-sensitivity cardiac troponin I (hs-TnI) levels at baseline were assessed in 3,623 patients with stable CAD and preserved systolic function enrolled in the PEACE (Prevention of Events With Angiotensin- Converting Enzyme Inhibitor Therapy) trial. Results: In total, 98.5% of patients had hs-TnI concentrations higher than the detection level (1.2 pg/ml). hs-TnI correlated moderately with hs-TnT (r = 0.44) and N-terminal pro-B-type natriuretic peptide (r = 0.39) but only weakly with age (r = 0.17) and estimated glomerular filtration rate (r = -0.11). During a median follow-up period of 5.2 years, 203 patients died of cardiovascular causes or were hospitalized for heart failure, and 209 patients had nonfatal myocardial infarctions. In analyses adjusting for conventional risk markers, N-terminal pro-B-type natriuretic peptide, and hs-TnT, hs-TnI levels in the fourth compared with the 3 lower quartiles were associated with the incidence of cardiovascular death or heart failure (hazard ratio: 1.88; 95% confidence interval: 1.33 to 2.66; p < 0.001). There was a significant, albeit weaker association with nonfatal myocardial infarction (hazard ratio: 1.44; 95% confidence interval: 1.03 to 2.01; p = 0.031). In the same models, hs-TnT concentrations were associated with the incidence of cardiovascular death or heart failure but not of myocardial infarction. Conclusions In patients with stable CAD, hs-TnI concentrations are associated with cardiovascular risk independently of conventional risk markers and hs-TnT.
AB - Objectives: The aims of this study were to assess the prognostic value of cardiac troponin I levels, measured with a new high-sensitivity assay, in low-risk patients with stable coronary artery disease (CAD) and to contrast its determinants and prognostic merit with that of high-sensitivity cardiac troponin T (hs-TnT). Background: New, highly sensitive cardiac troponin assays permit evaluation of the association between troponin levels and outcomes in patients with stable CAD. Methods: High-sensitivity cardiac troponin I (hs-TnI) levels at baseline were assessed in 3,623 patients with stable CAD and preserved systolic function enrolled in the PEACE (Prevention of Events With Angiotensin- Converting Enzyme Inhibitor Therapy) trial. Results: In total, 98.5% of patients had hs-TnI concentrations higher than the detection level (1.2 pg/ml). hs-TnI correlated moderately with hs-TnT (r = 0.44) and N-terminal pro-B-type natriuretic peptide (r = 0.39) but only weakly with age (r = 0.17) and estimated glomerular filtration rate (r = -0.11). During a median follow-up period of 5.2 years, 203 patients died of cardiovascular causes or were hospitalized for heart failure, and 209 patients had nonfatal myocardial infarctions. In analyses adjusting for conventional risk markers, N-terminal pro-B-type natriuretic peptide, and hs-TnT, hs-TnI levels in the fourth compared with the 3 lower quartiles were associated with the incidence of cardiovascular death or heart failure (hazard ratio: 1.88; 95% confidence interval: 1.33 to 2.66; p < 0.001). There was a significant, albeit weaker association with nonfatal myocardial infarction (hazard ratio: 1.44; 95% confidence interval: 1.03 to 2.01; p = 0.031). In the same models, hs-TnT concentrations were associated with the incidence of cardiovascular death or heart failure but not of myocardial infarction. Conclusions In patients with stable CAD, hs-TnI concentrations are associated with cardiovascular risk independently of conventional risk markers and hs-TnT.
KW - Cardiovascular death
KW - Coronary artery disease
KW - Natriuretic Peptides
KW - Troponin
UR - http://www.scopus.com/inward/record.url?scp=84877357582&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877357582&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2012.12.026
DO - 10.1016/j.jacc.2012.12.026
M3 - Article
C2 - 23414791
AN - SCOPUS:84877357582
SN - 0735-1097
VL - 61
SP - 1240
EP - 1249
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 12
ER -