Abstract 18494: Highly Sensitive Cardiac Troponin T is Associated with Incident Major Cardiovascular Events and Death: the Atherosclerosis Risk in Communities (ARIC) Study
Introduction: High sensitivity troponin T (hsTnT) assays are able to detect significantly lower levels compared to prior assays, which have a detection limit of 0.01ug/L. We hypothesized that trace levels of hsTnT are associated with mortality and cardiovascular events in individuals without prevalent cardiovascular disease (CVD) enrolled in the ARIC study; a large prospective epidemiologic study conducted in four communities in the U.S.
Methods: HsTnT was measured (Roche Diagnostics, lower detection limit 0.003μg/L) in 10,820 participants from visit 4 (visit dates 1996-1998), 9,713 without prevalent CVD. Outcome measures included death (n=1215), fatal CHD (n=117), CHF hospitalization (n=770), any stroke (n=340), ischemic stroke (n=299), unstable angina (n=486), and a composite of fatal CHD, definite or probable MI, or coronary revascularization (n=985) over a mean follow up of 9.9 years. Associations between hsTnT and cardiovascular outcomes were tested with Cox-proportional hazards models adjusting for traditional risk factors, diabetes, hsCRP, and NTproBNP.
Results: The mean age of subjects without prevalent CVD was 62.6 years (SD 5.6 yrs), 59% were women, and 78% were white. Measurable levels of hsTnT were detected in 61% (n=5,921) of individuals. The median value of hsTnT in the population was 0.005ug/L. Levels of hsTnT above the 75th percentile were independently associated with all outcomes tested. There was a significant association with death and hospitalization for heart failure at all detectable levels of hsTnT (Table).
Conclusion: Trace levels of troponin T are detectable in the majority of adults aged 53-75 without CVD. Levels of troponin T well below the detection limit of currently used assays are strongly associated with death and cardiovascular outcomes independent of traditional risk factors, diabetes, hsCRP, and NTproBNP. The value of this assay in improving CV risk prediction warrants further investigation.
- © 2010 by American Heart Association, Inc.