Abstract | IMPORTANCE AND OBJECTIVE: DESIGN, SETTING AND PARTICIPANTS:
Troponin I concentrations were measured using a contemporary-sensitivity, high-sensitivity, and super-sensitivity assay in 7,899 participants of the general-population based FINRISK 1997 cohort. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for over-optimism. MAIN OUTCOME: RESULTS: Values above the lower limit of detection were observed in 26.4%, 81.5% and 93.9% for the contemporary-sensitivity, high-sensitivity and super-sensitivity assay, respectively. We observed significant associations of troponin concentrations with the risk of future CVD events and the results tended to become stronger with increasing assay sensitivity. For the super-sensitivity assay the multivariate adjusted hazard ratios (per one standard deviation increase) for different outcomes were: MI 1.24 [95% CI 1.11-1.39], stroke 1.14 [1.01-1.28], CVD 1.15 [1.07-1.24], HF 1.28 [1.18-1.39], and MACE 1.18 [1.11-1.25]. In subjects with intermediate risk, we found an improvement of net reclassification for HF (10.2%, p<0.001), and MACE (5.1%, p<0.001). CONCLUSION: Using a super-sensitivity assay, cardiac troponin was detectable in almost all healthy individuals. Its concentration improved risk prediction and reclassification for cardiovascular endpoints.
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Authors | Johannes Tobias Neumann, Aki S Havulinna, Tanja Zeller, Sebastian Appelbaum, Tarja Kunnas, Seppo Nikkari, Pekka Jousilahti, Stefan Blankenberg, Karsten Sydow, Veikko Salomaa |
Journal | PloS one
(PLoS One)
Vol. 9
Issue 3
Pg. e90063
( 2014)
ISSN: 1932-6203 [Electronic] United States |
PMID | 24594734
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Aged
- Cardiovascular Diseases
(diagnosis)
- Endpoint Determination
- Female
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Proportional Hazards Models
- Prospective Studies
- Risk Assessment
- Sensitivity and Specificity
- Troponin
(metabolism)
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