OBJECTIVES: This study sought to assess changes in troponin levels, underlying conditions, and the prognostic implications in elderly subjects from the community. BACKGROUND: Cardiac troponin levels are often detectable in community dwellers when sensitive assays are applied. However, information on the course of troponin levels over time is limited. METHODS: Cardiac troponin I (cTnI) was measured by using a novel, high-sensitive assay in community dwellers aged 70 years from the Prospective Investigation of the Vasculature in Uppsala Seniors study. Measurements were performed at baseline (n = 1,004) and after 5 years (n = 814). Total follow-up was 8.0 years. RESULTS: cTnI levels were detectable in 968 (96.4%) subjects at baseline and independently predicted all-cause mortality (adjusted hazard ratio [HR]: 1.44 [95% confidence interval (CI): 1.18 to 1.77]) and cardiovascular mortality (adjusted HR: 1.66 [95% CI: 1.20 to 2.29]) when levels from baseline and 5-year follow-up were used as updated covariates. The integrated discrimination improvement of cTnI regarding all-cause mortality was 0.014 (p = 0.04), and the category-free net reclassification improvement was 0.231 (p = 0.02). Median cTnI levels increased by 45% between both measurements. The change in cTnI levels was significantly related to male sex (p = 0.02), body mass index (p = 0.01), high-density lipoprotein cholesterol (p = 0.005), N-terminal pro-B-type natriuretic peptide (p = 0.004), and left ventricular ejection fraction (p = 0.04), and it independently predicted all-cause mortality occurring after 5-year follow-up (adjusted HR: 1.97 [95% CI: 1.14 to 3.40]; p = 0.02). CONCLUSIONS: Using a novel high-sensitive assay, cTnI levels could be determined in nearly all elderly study subjects. cTnI levels increased over time and were a strong marker of mortality risk. Our data suggest that cTnI might offer utility for clinical assessment of subjects in the general population.
OBJECTIVES: This study sought to assess changes in troponin levels, underlying conditions, and the prognostic implications in elderly subjects from the community. BACKGROUND: Cardiac troponin levels are often detectable in community dwellers when sensitive assays are applied. However, information on the course of troponin levels over time is limited. METHODS:Cardiac troponin I (cTnI) was measured by using a novel, high-sensitive assay in community dwellers aged 70 years from the Prospective Investigation of the Vasculature in Uppsala Seniors study. Measurements were performed at baseline (n = 1,004) and after 5 years (n = 814). Total follow-up was 8.0 years. RESULTS:cTnI levels were detectable in 968 (96.4%) subjects at baseline and independently predicted all-cause mortality (adjusted hazard ratio [HR]: 1.44 [95% confidence interval (CI): 1.18 to 1.77]) and cardiovascular mortality (adjusted HR: 1.66 [95% CI: 1.20 to 2.29]) when levels from baseline and 5-year follow-up were used as updated covariates. The integrated discrimination improvement of cTnI regarding all-cause mortality was 0.014 (p = 0.04), and the category-free net reclassification improvement was 0.231 (p = 0.02). Median cTnI levels increased by 45% between both measurements. The change in cTnI levels was significantly related to male sex (p = 0.02), body mass index (p = 0.01), high-density lipoprotein cholesterol (p = 0.005), N-terminal pro-B-type natriuretic peptide (p = 0.004), and left ventricular ejection fraction (p = 0.04), and it independently predicted all-cause mortality occurring after 5-year follow-up (adjusted HR: 1.97 [95% CI: 1.14 to 3.40]; p = 0.02). CONCLUSIONS: Using a novel high-sensitive assay, cTnI levels could be determined in nearly all elderly study subjects. cTnI levels increased over time and were a strong marker of mortality risk. Our data suggest that cTnI might offer utility for clinical assessment of subjects in the general population.
Authors: John W McEvoy; Yuan Chen; Chiadi E Ndumele; Scott D Solomon; Vijay Nambi; Christie M Ballantyne; Roger S Blumenthal; Josef Coresh; Elizabeth Selvin Journal: JAMA Cardiol Date: 2016-08-01 Impact factor: 14.676
Authors: Xiaoming Jia; Wensheng Sun; Ron C Hoogeveen; Vijay Nambi; Kunihiro Matsushita; Aaron R Folsom; Gerardo Heiss; David J Couper; Scott D Solomon; Eric Boerwinkle; Amil Shah; Elizabeth Selvin; James A de Lemos; Christie M Ballantyne Journal: Circulation Date: 2019-04-29 Impact factor: 29.690
Authors: John W McEvoy; Mariana Lazo; Yuan Chen; Lu Shen; Vijay Nambi; Ron C Hoogeveen; Christie M Ballantyne; Roger S Blumenthal; Josef Coresh; Elizabeth Selvin Journal: Int J Cardiol Date: 2015-04-01 Impact factor: 4.164