High-Sensitivity Troponin-T and Cardiovascular Outcomes in the Community: Differences Between Women and Men

Suthahar, Navin; Meems, L. M. G.; Veldhuisen, Dirk J. van; Walter, Joan; Gansevoort, Ron T.; Heymans, Stéphane; Schroen, Blanche; Harst, Pim van der; Kootstra‐Ros, Jenny E.; Empel, Vanessa van; Müeller, Christian; Bakker, Stephan J. L.; Boer, Rudolf A. de

doi:10.1016/j.mayocp.2020.01.017

Cited by 11 publications

(16 citation statements)

References 43 publications

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“…A stronger association of baseline hs-cTnT values to cardiovascular events and mortality has been shown for females and further supports the possible impact of hs-cTnT in female patients with cancer. 32 ACM was higher in the present study (14.2% compared with 6.2% in the CARDIOTOX registry). The percentage of patients who experienced a drop in left ventricular function (4.3% in the present study, 5% in the CARDIOTOX registry) was comparable between both studies.…”

Section: Identification Of Patients At Risk and Follow-upcontrasting

confidence: 75%

High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study

et al. 2021

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Aims Cardio-oncology is a growing interdisciplinary field which aims to improve cardiological care for cancer patients in order to reduce morbidity and mortality. The impact of cardiac biomarkers, echocardiographic parameters, and cardiological assessment regarding risk stratification is still unclear. We aimed to identify potential parameters that allow an early risk stratification of cancer patients. Methods and resultsIn this cohort study, we evaluated 930 patients that were admitted to the cardio-oncology outpatient clinic of the University Hospital Heidelberg from January 2016 to January 2019. We performed echocardiography, including Global Longitudinal Strain (GLS) analysis and measured cardiac biomarkers including N-terminal pro brain-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T levels (hs-cTnT). Most patients were suffering from breast cancer (n = 450, 48.4%), upper gastrointestinal carcinoma (n = 99, 10.6%) or multiple myeloma (n = 51, 5.5%). At the initial visit, we observed 86.7% of patients having a preserved left ventricular ejection fraction (LVEF >50%). At the second follow up, still 78.9% of patients showed a preserved LVEF. Echocardiographic parameters or elevation of NT-proBNP did not significantly correlate with all-cause mortality (ACM) (logistic regression LVEF <50%: P = 0.46, NT-proBNP: P = 0.16) and failed to identify high-risk patients. In contrast, hs-cTnT above the median (≥7 ng/L) was an independent marker to determine ACM (multivariant logistic regression, OR: 2.21, P = 0.0038) among all included patients. In particular, hs-cTnT levels before start of a chemotherapy were predictive for ACM. Conclusions Based on our non-selected cohort of cardio-oncological patients, hs-cTnT was able to identify patients with high mortality by using a low cutoff of 7 ng/L. We conclude that measurement of hs-cTnT is an important tool to stratify the risk for mortality of cancer patients before starting chemotherapy.

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Section: Identification Of Patients At Risk and Follow-upcontrasting

confidence: 75%

High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study

et al. 2021

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“…There are also high-quality data demonstrating the independent predictive value of cardiac troponins (beyond NPs) for incident HF. 11,18,23,25 Our study adds granularity to these findings, and specifically highlights the potential value of combined NT-proBNP and cTnT measurements to improve HF risk prediction in overweight and obese individuals.…”

Section: Associations Of Selected Biomarkers With Incident Heart Failure Across Body Mass Index Categoriesmentioning

confidence: 58%

“…cTnT was measured using a fifth-generation high-sensitivity assay (Roche Modular E170, Roche Diagnostics). 11 The coefficient of variation at the 99th percentile of the reference range (14 ng/L) was <10%. Above 30 ng/L, cTnT inter-assay coefficients of variation were between 1% and 5% for all test applications.…”

Section: Baseline Measurementsmentioning

confidence: 89%

“…The Prevention of Renal and Vascular End-stage Disease (PREVEND) study (1997)(1998)) is an observational cohort study enrolling 8592 participants, and has been described elsewhere. [9][10][11] From the baseline cohort, we excluded 390 participants (4.5%) for the following reasons: (i) missing data on BMI (n = 93), (ii) BMI <18.5 kg/m 2 (n = 74), (iii) estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 (n = 11), and (iv) missing data on clinical covariates (n = 212). This resulted in 8202 participants eligible for the present investigation (online supplementary Figure S1), of which none had prevalent HF.…”

Section: Methodsmentioning

confidence: 99%

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Relationship between body mass index, cardiovascular biomarkers and incident heart failure

Suthahar

Meems

Groothof

et al. 2021

European J of Heart Fail

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“…The PREVEND study (1997)(1998)) is a Dutch cohort taken from the general population of Groningen, the Netherlands. [17][18][19] This study was designed to prospectively evaluate whether increased urinary albumin excretion (UAE) in community-dwelling individuals was associated with cardiovascular and renal disease. 20 In brief, all inhabitants from Groningen, aged 28 to 75 years were asked to respond to a short questionnaire and provide early-morning urine samples (N = 85,421), and 40,856 individuals (47.8%) responded.…”

Section: Methodsmentioning

confidence: 99%

Associations of Novel Indices of Adiposity with Incident Heart Failure

Suthahar

Meems

Withaar

et al. 2021

Preprint

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Objective: To examine associations of newly-developed adiposity indices with incident heart failure (HF).Participants and Methods: The current study included 8493 adults from the PREVEND observational cohort (mean age: 49.8 years; 50% women). Exposures included novel adiposity indices i.e., relative fat mass (RFM), body-roundness index (BRI), weight-adjusted-waist index and body-shape index (BSI), as well as established adiposity indices i.e., body-mass index (BMI), waist circumference, and waist-hip ratio (WHR). Main outcome was development of incident HF.Results: The prevalence of overweight (BMI: 25-30kg/m2) and obesity (BMI≥30kg/m2) were 41% and 17% respectively. During 11.3±3.1 years of follow-up, 372 HF events were recorded, resulting in an overall HF incidence of 3.88 per 1000 person-years. All novel adiposity indices, except BSI, were significantly associated with incident HF (P<0.001). BMI, WC and WHR were also significantly associated with incident HF (P<0.001). Sex did not modify the association of any adiposity index with incident HF (Pint>0.1). Amongst adiposity indices, RFM displayed the strongest effect sizes (HR:1.67, 95%CI, 1.37-2.03). This trend persisted across multiple age categories, BMI categories and also among HF subtypes. All obesity measures, except BSI, improved the fit of the clinical HF model. Strongest improvement was observed after adding BRI and RFM (reduction in Akaike information criteria: 26.5 and 24.4 respectively).Conclusions: Relative fat mass is strongly associated with incident HF in the community. Future studies should examine the value of novel adiposity indices in HF risk estimation.

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High-Sensitivity Troponin-T and Cardiovascular Outcomes in the Community: Differences Between Women and Men

Cited by 11 publications

References 43 publications

High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study

High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study

Relationship between body mass index, cardiovascular biomarkers and incident heart failure

Associations of Novel Indices of Adiposity with Incident Heart Failure

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