High-sensitivity cardiac troponin for risk prediction in patients with and without coronary heart disease

Hochholzer, Willibald; Valina, Christian; Stratz, Christian; Amann, Michael; Schlittenhardt, Daniel; Büttner, Heinz Joachim; Trenk, Dietmar; Neumann, Franz‐Josef

doi:10.1016/j.ijcard.2014.07.094

Cited by 21 publications

(20 citation statements)

References 30 publications

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“…This is consistent with other reports indicating that troponin elevation may be a useful predictor of poor health outcomes, even if only mildly elevated and below thresholds typically seen in ACS [16,17]. In our sample, black patients had higher troponin levels compared to whites (median 0.77 ng/ml vs. 0.39 ng/ml).…”

Section: Discussionsupporting

confidence: 92%

Troponin elevation predicts critical care needs and in-hospital mortality after thrombolysis in white but not black stroke patients

Faigle

Marsh

Llinás

et al. 2016

Journal of Critical Care

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Introduction Stroke patients undergoing intravenous thrombolysis (IVT) are at increased risk for critical care interventions and mortality. Cardiac troponin elevation is common in stroke patients; however, its prognostic significance is unclear. The present study evaluates troponin elevation as a predictor of critical care needs and mortality in post-IVT patients, and describes racial differences in its predictive accuracy. Methods Logistic regression and receiver operating characteristics (ROC) analysis were used to determine racial differences in the predictive accuracy of troponin elevation for critical care needs and mortality in post-IVT patients. Results Troponin elevation predicted critical care needs in white (OR 29.40, 95% CI 4.86–177.81) but not black patients (OR 0.50, 95% CI 0.14–1.78; p-value for interaction <0.001). Adding troponin elevation to a prediction model for critical care needs in whites improved the area under the curve (AUC) from 0.670 to 0.844 (p=0.006); however, addition of troponin elevation did not improve the model in blacks (AUC 0.843 vs. 0.851, p=0.54). Troponin elevation was associated with in-hospital mortality in whites (OR 21.94, 95% CI 3.51–137.11) but not blacks (OR 1.10, 95% CI 0.19–6.32; p-value for interaction 0.022). Conclusion Troponin is a useful predictor of poor outcome in white but not black post-IVT stroke patients.

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Section: Discussionsupporting

confidence: 92%

Troponin elevation predicts critical care needs and in-hospital mortality after thrombolysis in white but not black stroke patients

Faigle

Marsh

Llinás

et al. 2016

Journal of Critical Care

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“…Moreover, levels of high-sensitivity troponin I assays in the cohort were low and below upper reference limits suggested in studies that rule out occult coronary artery disease. 15,16 In the absence of clinical disease, our results provide preliminary evidence that associations between skeletal muscle and myocardium preexist.…”

Section: Discussionmentioning

confidence: 54%

Associations between Skeletal Muscle and Myocardium in Aging: A Syndrome of “Cardio‐Sarcopenia”?

Keng

Gao

Teo

et al. 2019

J American Geriatrics Society

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Objectives The link between skeletal muscle and heart disease remains intriguing. It is unknown how skeletal muscle may be associated with aspects of myocardial structure and function, particularly in the presence of aging‐related sarcopenia. We hypothesize that among aging adults with sarcopenia, alterations in myocardial structure and/or function may exist, resulting in a syndrome of “cardio‐sarcopenia.” Methods Participants derived from a community cohort study underwent same‐day bioimpedance body composition analysis that measured skeletal muscle in sites such as the trunk, upper limb, and lower limb, and echocardiography for assessment of myocardial structure and function. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria. Results We studied a total of 378 participants, of whom 88 (23.3%) had sarcopenia. Participants with sarcopenia had smaller left ventricular (LV) sizes (lower LV internal diameter end diastole (4.1 ± .7 vs 4.5 ± .6 cm; P < .0001), lower LV internal diameter end systole (2.3 ± .5 vs 2.5 ± .4 cm; P = .010), lower LV posterior wall end diastole (.7 ± .1 vs .8 ± .1 cm; P = .0036), and lower LV posterior wall end systole (1.4 ± .3 vs 1.5 ± .2 cm; P = .0031). Sarcopenic participants also had lower LV mass (106 ± 35 vs 126 ± 53; P = .0014) and lower left atrial (LA) volume (33 ± 13 vs 36 ± 13; P = .033). Adjusting for age and diabetes mellitus, skeletal muscle mass was associated with LV diameter (β = .06; 95% confidence interval [CI] = .03‐.09; P < .0001), LV mass (β = 4.04; 95% CI = 1.78‐6.29; P = .001), LA diameter (β = .05; 95% CI = .01‐.09; P = .007), and LA volume (β = 1.26; 95% CI = .38‐2.13; P = .005). A positive linear correlation was observed between LV mass and handgrip strength (r = .25; P < .0001). Conclusion Among a community sample of older adults with preserved heart function, sarcopenia is associated with reductions in LV and LA sizes. Skeletal muscle mass was independently associated with specific indices of myocardial structure. J Am Geriatr Soc 67:2568–2573, 2019

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“…(1,2) Moreover, in patients free from cardiovascular disease, raised levels of hs-cTnT have also been associated with higher risk of all-cause mortality and myocardial infarction. (3) Cardiovascular diseases are important risk factors for cognitive impairment and dementia. (4) Recent evidence shows that in subjects without cardiovascular disease, higher levels of hs-cTnT are associated with silent brain infarcts and white matter lesion progression.…”

Section: Introductionmentioning

confidence: 99%

High-sensitivity cardiac troponin T is associated with cognitive decline in older adults at high cardiovascular risk

Wijsman

Craen

Trompet

et al. 2016

Eur J Prev Cardiolog

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Aims Cardiac troponin T (cTnT), measured with a high-sensitivity (hs) assay, is associated with cognitive decline, but the underlying mechanism is unknown. We investigated the association of hs-cTnT with cognitive function and decline, and studied whether this association was independent of cardiovascular diseases or risk factors, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Methods and ResultsWe studied 5407 participants (mean age 75.31 years) from the PROspective Study of Pravastatin in the Elderly at Risk, who all had cardiovascular diseases or risk factors thereof. Participants with pre-existent advanced clinical heart failure were excluded. Hs-cTnT and NT-proBNP obtained after 6 months of follow-up were related with cognitive function, tested repeatedly during a mean follow-up of 3.2 years. Conclusions Higher levels of hs-cTnT associate with worse cognitive function and steeper cognitive decline in older adults independent of cardiovascular diseases, risk factors and NT-proBNP.

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High-sensitivity cardiac troponin for risk prediction in patients with and without coronary heart disease

Cited by 21 publications

References 30 publications

Troponin elevation predicts critical care needs and in-hospital mortality after thrombolysis in white but not black stroke patients

Troponin elevation predicts critical care needs and in-hospital mortality after thrombolysis in white but not black stroke patients

Associations between Skeletal Muscle and Myocardium in Aging: A Syndrome of “Cardio‐Sarcopenia”?

High-sensitivity cardiac troponin T is associated with cognitive decline in older adults at high cardiovascular risk

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