|Title||Premorbid levels of high-sensitivity cardiac troponin T and natriuretic peptide and prognosis after incident myocardial infarction.|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||Mok Y, Sang Y, Ballew SH, Hoogeveen RC, Ballantyne CM, Rosamond WD, Coresh JJ, Selvin E|
|Secondary Authors||Matsushita K|
|Journal||Am Heart J|
|Date Published||2019 10|
|Keywords||Aged, Asymptomatic Diseases, Biomarkers, Cohort Studies, Female, Humans, Incidence, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction, Natriuretic Peptide, Brain, Peptide Fragments, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Assessment, Sensitivity and Specificity, Survival Analysis, Troponin T, United States|
High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) at the time of myocardial infarction (MI) are strong predictors of prognosis. However, whether their premorbid (before MI occurrence) levels are associated with prognosis after incident MI is unknown.
METHODS: In 1,054 participants from the Atherosclerosis Risk in Communities Study with incident MI, we evaluated premorbid levels of hs-cTnT and NT-proBNP measured on median 5.8 (interquartile interval 3.0-11.5 [mean 5.5]) years prior to incident MI and their associations with subsequent composite and individual outcomes of all-cause mortality, cardiovascular mortality, recurrent MI, heart failure, and stroke.
RESULTS: During a median follow-up of 3.0 years after MI, 801 participants developed the composite outcome. Both hs-cTnT and NT-proBNP were independently associated with the composite outcome after incident MI. Among individual outcomes, all-cause mortality, cardiovascular mortality, and heart failure showed significant associations with both cardiac markers. Overall, NT-proBNP demonstrated a more evident relationship than hs-cTnT. Indeed, the addition of premorbid NT-proBNP alone, but not hs-cTnT alone, to conventional predictors at incident MI significantly improved risk prediction of the composite outcome after incident MI (Δc-statistic 0.013 [95% CI 0.005-0.022] from 0.691 with conventional predictors).
CONCLUSIONS: Premorbid levels of hs-cTnT and NT-proBNP assessed on average 6 years prior to incident MI were associated with adverse outcomes after incident MI. These results further highlight the importance of cardiac health at an earlier stage of life.
|Alternate Journal||Am Heart J|
|PubMed Central ID||PMC6842707|
|Grant List||R01 DK089174 / DK / NIDDK NIH HHS / United States |
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
R01 HL134320 / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States