6-year change in high sensitivity cardiac troponin T and the risk of atrial fibrillation in the Atherosclerosis Risk in Communities cohort.
atrial fibrillation
hs-cTnT
risk prediction
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
27
08
2021
received:
28
01
2021
accepted:
13
09
2021
pubmed:
22
9
2021
medline:
10
11
2021
entrez:
21
9
2021
Statut:
ppublish
Résumé
Circulating high sensitivity cardiac troponin T (hs-cTnT) is associated with incidence of atrial fibrillation (AF), but the association of changes in hs-cTnT over time on incident AF has not been explored. Six-year increase in circulating hs-cTnT will be associated with increased risk of AF and will contribute to improved prediction of incident AF. We conducted a prospective cohort analysis of 8431 participants from the Atherosclerosis Risk in Communities (ARIC) study. hs-cTnT change was categorized at visit 2 and 4 as undetectable (<5 ng/L), detectable (≥5 ng/L, <14 ng/L), or elevated (≥14 ng/L). We used Cox regression to examine the association between the combination of hs-cTnT categories at two visits and incident AF. We also assessed the impact of adding absolute hs-cTnT change on risk discrimination for AF by C-statistics and net reclassification improvement (NRI). Over a mean follow-up of 16.5 years, 1629 incident AF cases were diagnosed. Among participants with undetectable hs-cTnT at visit 2, the multivariable HR of AF was 1.28 (95% CI 1.12-1.48) among those with detectable or elevated hs-cTnT at visit 4 compared to those in which hs-cTnT remained undetectable. Among those with detectable hs-cTnT at visit 2, compared to those who remained in the detectable hs-cTnT group, reduction to undetectable at visit 4 was associated with lower risk of AF (HR 0.74, 95% CI 0.59-0.94), while increment to elevated was associated with higher AF risk (HR 1.30, 95% CI 1.01-1.68). Adding hs-cTnT change to our main model with baseline hs-cTnT did not result in significant improvement in the C-statistic or substantial NRI. Six-year increase in circulating hs-cTnT was associated with elevated risk of incident AF.
Sections du résumé
BACKGROUND
BACKGROUND
Circulating high sensitivity cardiac troponin T (hs-cTnT) is associated with incidence of atrial fibrillation (AF), but the association of changes in hs-cTnT over time on incident AF has not been explored.
HYPOTHESIS
OBJECTIVE
Six-year increase in circulating hs-cTnT will be associated with increased risk of AF and will contribute to improved prediction of incident AF.
METHODS
METHODS
We conducted a prospective cohort analysis of 8431 participants from the Atherosclerosis Risk in Communities (ARIC) study. hs-cTnT change was categorized at visit 2 and 4 as undetectable (<5 ng/L), detectable (≥5 ng/L, <14 ng/L), or elevated (≥14 ng/L). We used Cox regression to examine the association between the combination of hs-cTnT categories at two visits and incident AF. We also assessed the impact of adding absolute hs-cTnT change on risk discrimination for AF by C-statistics and net reclassification improvement (NRI).
RESULTS
RESULTS
Over a mean follow-up of 16.5 years, 1629 incident AF cases were diagnosed. Among participants with undetectable hs-cTnT at visit 2, the multivariable HR of AF was 1.28 (95% CI 1.12-1.48) among those with detectable or elevated hs-cTnT at visit 4 compared to those in which hs-cTnT remained undetectable. Among those with detectable hs-cTnT at visit 2, compared to those who remained in the detectable hs-cTnT group, reduction to undetectable at visit 4 was associated with lower risk of AF (HR 0.74, 95% CI 0.59-0.94), while increment to elevated was associated with higher AF risk (HR 1.30, 95% CI 1.01-1.68). Adding hs-cTnT change to our main model with baseline hs-cTnT did not result in significant improvement in the C-statistic or substantial NRI.
CONCLUSION
CONCLUSIONS
Six-year increase in circulating hs-cTnT was associated with elevated risk of incident AF.
Identifiants
pubmed: 34545585
doi: 10.1002/clc.23727
pmc: PMC8571551
doi:
Substances chimiques
Biomarkers
0
Troponin T
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1594-1601Subventions
Organisme : NHLBI NIH HHS
ID : K24 HL152440
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK089174
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24HL148521
Pays : United States
Organisme : American Heart Association-American Stroke Association
ID : 16EIA26410001
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004C
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL134320
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003I
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL148521
Pays : United States
Organisme : NIDDK NIH HHS
ID : K24 DK106414
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005I
Pays : United States
Informations de copyright
© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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