Kun Zhu1, Joseph Hung2, Mark Divitini3, Kevin Murray3, Ee Mun Lim4, Andrew St John5, John P Walsh1, Matthew Knuiman3. 1. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia. 2. Medical School, University of Western Australia, Crawley, Western Australia, Australia. Electronic address: joe.hung@uwa.edu.au. 3. School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia. 4. Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia. 5. ARC Consulting, Mount Lawley, Western Australia, Australia.
Abstract
OBJECTIVE: The identification of individuals at risk of atrial fibrillation (AF) remains a challenge. We investigated whether high-sensitive cardiac troponin I (hs-cTnI) is an independent predictor of incident atrial fibrillation (AF) hospitalisation in an Australian community-based cohort. METHODS: Serum hs-cTnI was measured in 1641 men and 2189 women in the Busselton Health Study 1994/1995 Cohort aged 25-84 years at baseline. Data on incident AF hospitalisation over 20 years follow-up were obtained by data linkage. RESULTS: Hs-cTnI was detectable (>1.2 ng/L) in 65.5% of participants (males 81.4%, females 53.6%) at baseline. There were 179 (10.9%) AF events in men and 208 (9.5%) in women. In the multivariable-adjusted model, hs-cTnI was a significant predictor of AF event with hazard ratio 1.21 (95% CI 1.11-1.32, P < 0.001) in the whole cohort, 1.17 (95% CI 1.01-1.35, P = 0.037) in men and 1.22 (95% CI 1.08-1.37, P = 0.001) in women for a doubling of baseline hs-cTnI. In women, a graded and significant increase in risk of AF was observed across hs-cTnI categories from ≥1.3 ng/L, whereas in men only the highest category (≥6.0 ng/L) had significantly increased risk compared with individuals with hs-cTnI ≤1.2 ng/L. Addition of categorical hs-cTnI to standard risk factors for AF improved risk estimation in females (C-statistic increment 0.006, P = 0.04) but not males (increment 0.005, P = 0.12) and net reclassification improvement was not significant in either sex. CONCLUSIONS: High-sensitive cTnI level is an independent predictor of incident AF hospitalisation in a community-based cohort but does not improve risk stratification.
OBJECTIVE: The identification of individuals at risk of atrial fibrillation (AF) remains a challenge. We investigated whether high-sensitive cardiac troponin I (hs-cTnI) is an independent predictor of incident atrial fibrillation (AF) hospitalisation in an Australian community-based cohort. METHODS: Serum hs-cTnI was measured in 1641 men and 2189 women in the Busselton Health Study 1994/1995 Cohort aged 25-84 years at baseline. Data on incident AF hospitalisation over 20 years follow-up were obtained by data linkage. RESULTS: Hs-cTnI was detectable (>1.2 ng/L) in 65.5% of participants (males 81.4%, females 53.6%) at baseline. There were 179 (10.9%) AF events in men and 208 (9.5%) in women. In the multivariable-adjusted model, hs-cTnI was a significant predictor of AF event with hazard ratio 1.21 (95% CI 1.11-1.32, P < 0.001) in the whole cohort, 1.17 (95% CI 1.01-1.35, P = 0.037) in men and 1.22 (95% CI 1.08-1.37, P = 0.001) in women for a doubling of baseline hs-cTnI. In women, a graded and significant increase in risk of AF was observed across hs-cTnI categories from ≥1.3 ng/L, whereas in men only the highest category (≥6.0 ng/L) had significantly increased risk compared with individuals with hs-cTnI ≤1.2 ng/L. Addition of categorical hs-cTnI to standard risk factors for AF improved risk estimation in females (C-statistic increment 0.006, P = 0.04) but not males (increment 0.005, P = 0.12) and net reclassification improvement was not significant in either sex. CONCLUSIONS: High-sensitive cTnI level is an independent predictor of incident AF hospitalisation in a community-based cohort but does not improve risk stratification.
Authors: Denise M S van Marion; Eva A H Lanters; Kennedy S Ramos; Jin Li; Marit Wiersma; Luciënne Baks-Te Bulte; Agnes J Q M Muskens; Eric Boersma; Natasja M S de Groot; Bianca J J M Brundel Journal: Cells Date: 2020-09-16 Impact factor: 6.600