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Relative Prognostic Value of Cardiac Troponin I and C-Reactive Protein in the General Population (from the Nord-Trøndelag Health [HUNT] Study)

The American journal of cardiology, 2018-04, Vol.121 (8), p.949-955 [Peer Reviewed Journal]

2018 Elsevier Inc. ;Copyright © 2018 Elsevier Inc. All rights reserved. ;Copyright Elsevier Sequoia S.A. Apr 15, 2018 ;info:eu-repo/semantics/openAccess ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2018.01.004 ;PMID: 29496193

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  • Title:
    Relative Prognostic Value of Cardiac Troponin I and C-Reactive Protein in the General Population (from the Nord-Trøndelag Health [HUNT] Study)
  • Author: Sigurdardottir, Fjola D. ; Lyngbakken, Magnus N. ; Holmen, Oddgeir L. ; Dalen, Håvard ; Hveem, Kristian ; Røsjø, Helge ; Omland, Torbjørn
  • Subjects: Body mass index ; C-reactive protein ; Calcium-binding protein ; Cardiovascular disease ; Cardiovascular diseases ; Cholesterol ; Confidence intervals ; Diabetes ; Family medical history ; Gender ; Health risk assessment ; Health risks ; Heart ; Heart diseases ; Hypertension ; Mathematical models ; Myocardial infarction ; Prediction models ; Proteins ; Reclassification ; Risk ; Sensitivity ; Triglycerides ; Troponin ; Troponin I ; Variables
  • Is Part Of: The American journal of cardiology, 2018-04, Vol.121 (8), p.949-955
  • Description: C-reactive protein and cardiac troponin I measured with high-sensitivity assays (high-sensitivity C-reactive protein [hs-CRP] and high-sensitivity troponin I [hs-TnI]) have been associated with risk of fatal and nonfatal cardiovascular events in the general population. The relative prognostic merits of hs-CRP and hs-TnI, and whether these markers of inflammation and subclinical myocardial injury provide incremental information to established cardiovascular risk prediction models, remain unclear. hs-CRP and hs-TnI were measured in 9,005 participants from the prospective observational Nord-Trøndelag Health (HUNT) study. All study subjects were free from known cardiovascular disease at baseline. During a median follow-up period of 13.9 years, 733 participants reached the composite end point of hospitalization for acute myocardial infarction or heart failure, or cardiovascular death. In adjusted models, increased hs-TnI concentrations (>10 ng/L for women and >12 ng/L for men) were associated with the incidence of the composite end point (hazard ratio 3.61, 95% confidence interval [CI] 2.89 to 4.51]), whereas the risk associated with increased hs-CRP concentrations (>3 mg/L for both genders) appeared to be weaker (HR 1.71, 95% CI 1.40 to 2.10). The addition of hs-TnI to established cardiovascular risk prediction models led to a net reclassification improvement of 0.35 (95% CI 0.27 to 0.42), superior to that of hs-CRP (0.21, 95% CI 0.13 to 0.28). The prognostic accuracy of hs-TnI, assessed by C-statistics, was significantly greater than that of hs-CRP (0.753, 95% CI 0.735 to 0.772, vs 0.644, 95% CI 0.625 to 0.663). In conclusion, in subjects from the general population without a history of cardiovascular disease, hs-TnI provides prognostic information superior to that provided by hs-CRP and may therefore be a preferred marker for targeted prevention.
  • Publisher: United States: Elsevier Inc
  • Language: English;Norwegian
  • Identifier: ISSN: 0002-9149
    EISSN: 1879-1913
    DOI: 10.1016/j.amjcard.2018.01.004
    PMID: 29496193
  • Source: NORA Norwegian Open Research Archives
    ProQuest Central
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