Abstract 16343: Cardiac Troponin I Provides Superior Prognostic Information to C-Reactive Protein in the General Population: Data From The Nord-Trøndelag Health Study
Background: Both C-reactive protein (CRP) and cardiac troponin I (cTnI) measured with high-sensitivity assays have been associated with risk of fatal and nonfatal cardiovascular events in the general population, but their relative prognostic value remains unclear.
Methods: CRP and cTnI were measured in 9005 participants from the prospective observational Nord-Trøndelag Health Study. All study subjects were free from known cardiovascular disease at baseline.
Results: During a median follow up period of 13.9 years, 733 participants reached the composite endpoint of hospitalization for acute myocardial infarction or heart failure, or cardiovascular death. In adjusted models, cTnI concentrations >10 ng/L for women and >12 ng/L for men were associated with the incidence of the composite endpoint (hazard ratio [HR] 3.23 [95% confidence interval (CI) 2.58-4.04]), while the risk associated with increased CRP concentrations (>3 mg/L for both sexes) was weaker (HR 1.61 [1.32-1.96]). The addition of cTnI to established cardiovascular risk prediction models led to a net reclassification improvement (NRI) of 0.35 (95% CI 0.27-0.42), superior to that of CRP (0.21 [0.13-0.28]). The prognostic accuracy expressed as the area under the ROC curve of cTnI was 0.75 (0.74-0.76) and significantly greater to that of CRP, AUC 0.64 (0.63-0.65).
Conclusion: In subjects from the general population without a history of cardiovascular disease, cTnI provides prognostic information superior to that provided by CRP measurements. This suggests that cTnI measurement may be a better tool for identifying individuals at high cardiovascular risk compared to CRP and therefore also a better marker for targeted prevention.
Author Disclosures: F.D. Sigurdardottir: None. M.N. Lyngbakken: None. O.L. Holmen: None. H. Dalen: None. K. Hveem: None. H. Røsjø: None. T. Omland: None.
- © 2017 by American Heart Association, Inc.