Abstract 12536: A Sensitive Cardiac Troponin T Assay and the Risk of Incident Cardiovascular Disease in Women with and without Diabetes: The Women's Health Study
Background: Very low levels of cardiac troponin T are associated with increased risk of cardiovascular death in patients with established but stable chronic coronary disease. Whether high-sensitivity cardiac troponin T (hsTNT) levels associate with adverse cardiovascular outcomes in a primary prevention population has not been well studied.
Methods and Results: Utilizing two complementary study designs, we evaluated the relationship between baseline hsTNT and incident cardiovascular disease (CVD) among diabetic and non-diabetic participants in the Women's Health Study. All women with baseline diabetes and available blood specimens were included in a cohort study (n=512 women, n=119 CVD events). Women without diabetes were sampled for inclusion in a case-cohort analysis (n=564 subcohort, n=450 CVD events). We used a new, highly sensitive assay to determine plasma levels of hsTNT. Apart from appropriate weighting by sampling probabilities in the case-cohort analysis, identical Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95%; CI's of future CVD for women with detectable as compared to undetectable hsTNT. Among diabetic women, hsTNT was detectable among 56.3%; with and 42.2%; without incident CVD (P=0.007). Among non-diabetic women, hsTNT was detectable among 34.0%; vs. 30.0%; (P=0.18) with and without incident CVD, respectively. In adjusted models, detectable hsTNT was associated with CVD in diabetic women (HR 1.55, 95%; CI 1.06–2.28, P=0.025), but not non-diabetic women (HR 1.12, 95%; CI 0.81–1.55, P=0.50). The association in diabetic women appeared driven by a nearly four-fold increase in CVD death, which was not observed in women without diabetes (Table).
Conclusions: Very low but detectable levels of cardiac troponin T are associated with total CVD, and CVD death in particular, in women with diabetes. Among healthy women without diabetes, detectable compared to undetectable troponin was not associated with CVD events.
- © 2010 by American Heart Association, Inc.