Abstract 12641: High-Sensitive troponin-T Strongly Predicts Cardiovascular Mortality in Community-Dwelling Older Adults: the Cardiovascular Health Study
Purpose: To determine the prognostic accuracy of troponin T measured with a high-sensitivity assay (hs-TnT) in predicting cardiovascular (CV) death in community-dwelling older adults.
Methods: We measured hs-TnT (Roche Elecsys; limit of blank: 3 pg/mL) in the CHS, a multi-center study of CV risk factors in community-dwelling older adults, in sera collected in 1989–90 or 1992–93 (at entry into CHS). CV mortality was determined prospectively as death due to atherosclerotic heart disease, fatal stroke, or death from other atherosclerotic and cardiovascular diseases. Cox survival regression was used to estimate the association between hs-TnT category and CV mortality, controlling for demographics and other CV risk factors (blood pressure, use of anti-hypertensive medications, diabetes, lipids levels, smoking, prior stroke, coronary heart disease, renal function, and presence of major ECG abnormalities).
Results: hs-TnT was measured in 4,221 (75.4%) participants free of heart failure at baseline. Median age was 71, 16.2% were African-American, 17.8% had coronary disease, and 59.5% had hypertension. Rate of CV mortality was 1.9/100 person-years over a median 2.5 years follow-up. Compared to those with hs-TnT concentrations below 3 pg/mL (34%), those with concentrations >12.94 pg/mL had 162% greater risk for CV death, after multivariable adjustment (table). The association of elevated hs-TnT and CV mortality did not differ significantly between those with (Hazard Ratio [HR]=2.2) and without coronary disease (HR=2.8; p for interaction=0.6).
Conclusions: hs-TnT is a strong predictor of long-term cardiovascular mortality in community-dwelling older adults, independent of co-morbidity and other risk factors. Measurement of hs-TnT may be useful for risk stratification in older adults with and without coronary disease.
- © 2010 by American Heart Association, Inc.