High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure: Results From the BiomarCaRE Consortium
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- High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure
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Objectives: The aims of this study were to characterize the association of high-sensitivity cardiac troponin I (hs-cTnI) with heart failure (HF), to determine its predictive value beyond classical cardiovascular risk factors (CVRFs) and N-terminal pro–B-type natriuretic peptide, and to derive a relevant cutoff for potential clinical application. Background: HF is an important contributor to the overall burden of cardiovascular disease. Early identification of individuals at risk could be beneficial for preventive therapies. Methods: Based on the Biomarker for Cardiovascular Risk Assessment in Europe consortium, we analyzed individual-level data from 4 prospective population-based cohort studies including 48,455 individuals. Participants with myocardial infarction, HF, and stroke at baseline were excluded. We investigated the value of adding hs-cTnI to CVRFs and N-terminal pro–B-type natriuretic peptide using Cox proportional hazards survival models and for prediction by calculating C-statistics and Brier score. Results: The median age of the study population was 51 years, and the median follow-up time for occurrence of HF was 6.61 years. Cox regression models adjusted for age, sex, and CVRFs revealed a significant association of hs-cTnI with incident HF (hazard ratio: 1.42 per log [ng/l] unit change [95% confidence interval: 1.31 to 1.53]). The best predictive value was achieved in the model with CVRFs (base model) and both biomarkers (C-index = 0.862; 95% confidence interval: 0.841 to 0.882). Optimal hs-cTnI cutoff values of 2.6 ng/l for women and 4.2 ng/l for men were derived for selecting individuals at risk. Conclusions: In this large dataset from the general population, hs-cTnI could show its independence for the prognosis of HF.
Original language | English |
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Journal | JACC: Heart Failure |
Volume | 8 |
Issue number | 5 |
Pages (from-to) | 401-411 |
ISSN | 2213-1779 |
DOIs | |
Publication status | Published - May 2020 |
- BiomarCaRE, cardiovascular risk factors, high-sensitivity cardiac troponin I, N-terminal pro-B-type natriuretic peptide, prediction of heart failure
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