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Troponin T, B-type natriuretic peptide, C-reactive protein, and cause-specific mortality.

TitleTroponin T, B-type natriuretic peptide, C-reactive protein, and cause-specific mortality.
Publication TypeJournal Article
Year of Publication2013
AuthorsOluleye OW, Folsom AR, Nambi V, Lutsey PL
Secondary AuthorsBallantyne CM
Corporate AuthorsARIC Study Investigators
JournalAnn Epidemiol
Volume23
Issue2
Pagination66-73
Date Published2013 Feb
ISSN1873-2585
KeywordsAged, Biomarkers, C-Reactive Protein, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Mortality, Natriuretic Peptide, Brain, Neoplasms, Population Surveillance, Predictive Value of Tests, Prevalence, Proportional Hazards Models, Prospective Studies, Respiration Disorders, Risk Factors, Surveys and Questionnaires, Troponin T
Abstract

PURPOSE: We sought to evaluate the associations of high-sensitivity troponin T (Hs-TnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and high sensitivity C-reactive protein (Hs-CRP) with mortality from any cause, cardiovascular disease (CVD), coronary heart disease (CHD), stroke, cancer, and respiratory disease in the Atherosclerosis Risk in Communities cohort.

METHODS: We included 11,193 participants aged 54 to 74 years, initially free of the conditions being studied, and who had biomarkers measured. Participants were followed for a mean of 9.9 years.

RESULTS: Hazard ratios (HR), adjusted for multiple risk factors, for mortality in participants in the highest Hs-TnT category compared with those with undetectable levels were: Total 3.42 (95% confidence interval [CI], 2.75-4.26); CVD, 7.34 (95% CI, 4.64-11.6); CHD, 6.06 (95% CI, 2.91-12.6); stroke, 3.31 (95% CI, 1.26-8.66); cancer, 1.60 (95% CI, 1.08-2.38); and respiratory, 3.85 (95% CI, 1.39-10.7). Comparing the highest NT-proBNP quintile with those in the lowest quintile, the adjusted HRs for mortality were: Total, 3.05 (95% CI, 2.46-3.77); CVD, 7.48 (95% CI, 4.67-12.0); CHD, 4.07 (95% CI, 2.07-7.98); and stroke, 10.4 (95% CI, 2.26-47.7). Comparing extreme Hs-CRP quintiles, the adjusted HRs for mortality were: Total, 1.61 (95% CI, 1.32-1.97); CVD, 1.76 (95% CI, 1.19-2.62); and respiratory, 3.36 (95% CI, 1.34-8.45). Having multiple markers elevated simultaneously greatly increased cause-specific mortality risks.

CONCLUSIONS: Greater levels of Hs-TnT, NT-proBNP and Hs-CRP are associated with increased risk of death, not just from CVD, but also from some noncardiovascular causes.

DOI10.1016/j.annepidem.2012.11.004
Alternate JournalAnn Epidemiol
PubMed ID23228375
PubMed Central IDPMC3543509
Grant ListHHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States