Abstract 17021: High Sensitive Cardiac Troponin T is Associated With Progression of Subclinical CVD: the Multi-Ethnic Study of Atherosclerosis (MESA)
Introduction: High sensitive cardiac troponin T (hs-cTnT) levels are associated with cross sectional imaging findings of abnormal left ventricular (LV) structure and function in community dwelling adults without known CVD.
Hypothesis: hs-cTnT level is associated with adverse LV remodeling and decline in LVEF, as measured by serial cardiac magnetic resonance (CMR) over 10 years.
Methods: 2831 of 6814 community-dwelling MESA participants, free of CVD at baseline and after 10 years, had a baseline CMR and hs-cTnT, and a repeat CMR at 10 years. Due to evolution of CMR techniques, calibration equations were utilized to compare measures between time points. An adverse LV change was defined as >twice the inter-observer difference: >12% increase in LV mass, >8% increase in LV end-diastolic volume (LVEDV) and a >8% decline in LVEF. hs-cTnT was measured on the Cobas e601 (Roche Diagnostics), limit of detection 3 ng/L. Poisson regression was used to estimate associations between hs-cTnT concentration and adverse LV change, and linear regression for continuous change in each CMR measure, adjusted for demographics, body size, and CVD risk factors.
Results: Mean age was 59.4±9.3 years, with 46.4% male. Overall 23.6% had an adverse increase in LV mass, 13.7% an increase in LVEDV and 15.2% had a >8% decline in LVEF. The adjusted risk for an increase in LV mass and LVEDV was greater with higher baseline hs-cTnT levels. In contrast, a decline in LVEF wasn’t associated with hs-cTnT (Table). There were also significant associations of hs-cTnT with continuous change in LV mass (p=.03) and LVEDV (p=.02), but not LVEF.
Conclusions: Biochemical evidence of myocyte injury, as measured by hs-cTnT, predicts subsequent adverse LV remodeling but not decline in systolic function, accounting for baseline characteristics. hs-cTnT may be considered an early signature for stage B heart failure, and may identify middle age and older adults most likely to benefit from early therapy to prevent LV remodeling.
Author Disclosures: S. Seliger: Research Grant; Significant; Roche Diagnostics. Consultant/Advisory Board; Significant; Abbvie. S. Hong-Zohlman: Other Research Support; Modest; Roche Diagnostics. J. deLemos: Other Research Support; Significant; Roche Diagnostics; Abbot. Consultant/Advisory Board; Significant; Radiometer; Siemens Healthcare; Roche Diagnostics. 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. J. Lima: None. L.B. Daniels: Research Grant; Modest; Siemens Healthcare. Speakers Bureau; Modest; Roche Diagnostics. Consultant/Advisory Board; Modest; diaDexus. A. Bertoni: None. 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.
- © 2016 by American Heart Association, Inc.