Abstract 16606: High-sensitive Cardiac Troponin T Level is Associated With Replacement Fibrosis in Community-dwelling Adults Without Known Cardiovascular Disease: the Multi-Ethnic Study of Atherosclerosis (MESA)
Introduction: Although small elevations of high sensitive cardiac troponin T (hs-cTnT) are associated with incident heart failure in the general population, the underlying mechanisms are not well defined.
Hypothesis: hs-cTnT level is associated with prevalent replacement fibrosis identified by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in CVD-free adults participating in the MESA study.
Methods: hs-cTnT was measured from previously frozen plasma (Cobas e601 [Roche Diagnostics] limit of detection [LOD] 3.0 ng/L) in 99.5% of 6814 MESA participants at baseline, of whom 1753 also underwent LGE CMR and were CVD-free 10-years later (Exam 5). Presence of LGE was interpreted in the MESA CMR core lab and further categorized as “typical” (ischemic) and “atypical” (non-ischemic) in pattern.
Results: Mean age was 58±9 years with 51.0% male. Concentrations of hs-cTnT were below LOD in 36.9%. Subjects with detectable hs-cTnT were divided into 4 additional equal subgroups based on hs-cTnT concentration. LGE was identified in 113 (6.3%); of these, 38 (33.6%) had an ischemic pattern, while 75 (66.4%) participants were classified as non-ischemic. Progressively higher categories of hs-cTnT level were associated with a higher prevalence of LGE with no significant difference in the distribution of LGE pattern across categories (figure). Participants in the highest hs-cTnT category were nearly 3 times as likely to have LGE scar compared to those with hs-cTnT <LOD, after adjustment for demographics, CVD risk factors, and eGFR (RR: 2.88, 95% CI: 1.37-5.94). There was a significant linear relationship between higher hscTnT and greater frequency of LGE scar (p=.03)
Conclusions: hs-cTnT level is associated with myocardial replacement fibrosis as represented by LGE CMR 10 years later in clinically CVD-free individuals. This supports the hypothesis that hs-cTnT is a measure of ongoing myocyte cell loss preceding clinically overt cardiac disease.
Author Disclosures: C. deFilippi: Research Grant; Significant; Roche Diagnostics, Critical Diagnostics. Other Research Support; Modest; Siemens Healthcare Diagnostics. Honoraria; Modest; Roche Diagnostics, Siemens Healthcare Diagnostics. Consultant/Advisory Board; Modest; Roche Diagnostics, Ortho Diagnostics. Consultant/Advisory Board; Significant; Siemens Healthcare Diagnostics. Other; Modest; Quintiles-DSMB, ajudicator. Other; Significant; Radiometer-Ajudicator. S. Hong-Zohlman: None. J. deLemos: Other Research Support; Significant; Roche Diagnostics; Abbot. Consultant/Advisory Board; Significant; Radiometer; Siemens Healthcare; Roche Diagnostics. L.B. Daniels: Research Grant; Modest; Siemens Healthcare. Speakers Bureau; Modest; Roche Diagnostics. Consultant/Advisory Board; Modest; diaDexus. J. Lima: None. A. Bertoni: None. R. Christenson: Research Grant; Modest; Roche Diagnostics. Speakers Bureau; Modest; Roche Diagnostics; Siemens Diagnostics. Consultant/Advisory Board; Modest; Roche Diagnostics, Siemens Diagnostics, BD Life Sciences, Phillips. S. Seliger: Research Grant; Significant; Roche Diagnostics. Consultant/Advisory Board; Significant; Abbvie.
- © 2016 by American Heart Association, Inc.