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High sensitivity troponin T and incident heart failure in older men: British Regional Heart Study.

Welsh, P; Papacosta, O; Ramsay, S; Whincup, P; McMurray, J; Wannamethee, G; Sattar, N (2019) High sensitivity troponin T and incident heart failure in older men: British Regional Heart Study. J Card Fail, 25 (4). pp. 230-237. ISSN 1532-8414 https://doi.org/10.1016/j.cardfail.2018.08.002
SGUL Authors: Whincup, Peter Hynes

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Abstract

AIM: To study the association of high sensitivity troponin T (hsTnT) with incident heart failure, and implications for its use in prediction models. METHODS AND RESULTS: The British Regional Heart Study of 3852 men aged 60-79 without baseline HF (3165 without baseline CHD) was followed up for a median of 12.6 years, during which 295 incident cases of HF occurred (7.7%). A 1 standard deviation increase in log-transformed hsTnT was associated with a higher risk of incident HF after adjusting for classical risk factors (HR 1.58 [95% CI 1.42, 1.77]) and after additional adjustment for NT-proBNP (HR 1.34 [95% CI 1.19, 1.52]). The strength of the association between hsTnT and incident HF did not differ by strata of other risk factors. A hsTnT concentration of <5ng/L had a sensitivity of 99.7% (95%CI 98.1-99.9%) and a specificity of 3.4% (95%CI 2.8%-4.0%). A risk prediction model including classic risk factors and NT-proBNP yielded a c-index of 0.791, but addition of hsTnT did not further improve prediction (p=0.28). CONCLUSIONS: Elevated hsTnT is consistently associated with risk of HF in older men. HF rarely occurs over 12 years when baseline hsTnT is below the limit of detection. hsTnT measurement, however, does not improve HF prediction in a model already containing NT proBNP.

Item Type: Article
Additional Information: © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Biomarkers, Heart failure, Risk prediction, Troponin T, Cardiovascular System & Hematology, 1103 Clinical Sciences, 1102 Cardiovascular Medicine And Haematology
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: J Card Fail
ISSN: 1532-8414
Language: eng
Dates:
DateEvent
April 2019Published
11 August 2018Published Online
3 August 2018Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
RG/08/013/25942British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
FS/12/62/29889British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PubMed ID: 30103019
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110056
Publisher's version: https://doi.org/10.1016/j.cardfail.2018.08.002

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