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

Oluleye, Oludamilola; Folsom, Aaron R.; Nambi, Vijay; Lutsey, Pamela L.; Ballantyne, Christie M.

doi:10.1016/j.annepidem.2012.11.004

Cited by 72 publications

(69 citation statements)

References 51 publications

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“…18 Interestingly, a longitudinal populationbased study showed that elevated cTn at baseline not only predicted cardiovascular death within the 10-year follow-up period (HR, 7.4; 95% CI, 4.6-11.6) but to a lower degree also death from stroke (HR, 3.3; 95% CI, 1.3-8.7), and cancer (HR, 1.6; 95% CI, 1.1-2.4). 56 Furthermore, cTn was independently associated with increased risk of incident stroke in the general population (HR, 1.13; 95% CI, 1.1-1.2; follow-up 20 years). 58 In patients with atrial fibrillation included in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, annual rates of stroke or systemic embolism during follow-up of 2 years ranged from 0.9% in the lowest cTn quartile to 2.1% in the highest quartile (HR, 1.9; 95% CI, 1.4-2.8).…”

Section: Future Perspectives: Possible Applicationsmentioning

confidence: 95%

“…This recommendation is based on the strong association between cTn levels and (subclinical) heart disease, future cardiovascular events and mortality. 16,17,56 If there is evidence of acute ischemic myocardial injury (dynamic pattern), clinicians should promptly attempt to identify the most probable cause of cTn elevation. 4,52 The pretest probability for MI increases with the presence of cardiovascular risk factors, ECG alterations suggestive of myocardial ischemia, typical chest discomfort, or dyspnea.…”

Section: Clinical Work-up Of Stroke Patients With Elevated Ctnmentioning

confidence: 99%

“…При выявлении заболевания сердца меро приятия профилактики сердечно-сосудистых забо-леваний следует активизировать или переоценить. Эта рекомендация основана на четкой ассоциации между уровнем cTn и (субклиническим) поражением сердца, риском развития в будущем сердечно-сосудистых небла-гоприятных событий и летального исхода [16,17,56].…”

Section: клиническое обследование пациентов с инсультом и повышенным unclassified

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Application and Interpretation of High-Sensitivity Cardiac Troponin Assays in Patients With Acute Ischemic Stroke

Scheitz

Nolte

Laufs

et al. 2015

Stroke

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Section: Future Perspectives: Possible Applicationsmentioning

confidence: 95%

Section: Clinical Work-up Of Stroke Patients With Elevated Ctnmentioning

confidence: 99%

Section: клиническое обследование пациентов с инсультом и повышенным unclassified

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Application and Interpretation of High-Sensitivity Cardiac Troponin Assays in Patients With Acute Ischemic Stroke

Scheitz

Nolte

Laufs

et al. 2015

Stroke

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“…[3][4][5][6][7][8][9][10] In addition, elevated hs-CRP has been shown to be a stronger predictor of cardiovascular disease than low-density lipoprotein cholesterol.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

“…2 Elevated hs-CRP levels have been associated with infl ammation, aging, cancer, adverse outcomes of angina pectoris, coronary artery disease, adverse outcomes of chronic obstructive pulmonary disease, stroke, and increased risk of mortality. [3][4][5][6][7][8][9][10] In addition, elevated hs-CRP has been shown to be a stronger predictor of cardiovascular disease than low-density lipoprotein cholesterol. 11 A recent study of more than 4,000 subjects followed for six years revealed that elevated hs-CRP was associated with type 2 diabetes.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Short Duration of Sleep Is Associated with Elevated High-Sensitivity C-Reactive Protein Level in Taiwanese Adults: A Cross-Sectional Study

Chiang¹

2014

Journal of Clinical Sleep Medicine

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Background: Elevated plasma levels of high-sensitivity C-reactive protein (hs-CRP) have been associated with increased adverse health outcomes. The aim of this study was to investigate the association of sleep duration with risk of elevated hs-CRP levels in Taiwanese adults. Methods: We examined the association between sleep duration and hs-CRP in 353 healthy adults recruited from the physical examination center at a regional hospital in southern Taiwan. Elevated hs-CRP was defi ned as a plasma level ≥ 0.20 mg/dL. Short sleep duration was defi ned as ≤ 5.5 h per day. Multiple logistic regression analysis was used to assess the association of short duration of sleep with elevated hs-CRP levels. Results: In this study, short duration of sleep (odds ratio [OR] = 2.20; 95% confi dence interval [CI]: 1.11-4.30), aged 70 years or older (OR = 4.58; 95% CI: 1.70-12.66), menopause (OR = 2.81; 95% CI: 1.52-5.3), higher heart rate (OR = 1.38; 95% CI: 1.10-1.75), higher body mass index (OR = 1.20; 95% CI: 1.09-1.34), higher white blood cell count (OR = 1.38; 95% CI: 1.14-1.66), and higher uric acid level (OR = 1.31; 95% CI: 1.06-1.63) were signifi cantly associated with an increased risk of elevated hs-CRP levels. Conclusions: In this study of healthy Taiwanese adults, short duration of sleep was signifi cantly associated with elevated hs-CRP levels. Activation of pro-infl ammatory pathways might represent a mechanism by which short sleep duration affects health. Keywords: sleep duration, C-reactive protein, high-sensitivity CRP, hs-CRP Citation: Chiang JK. Short duration of sleep is associated with elevated high-sensitivity C-reactive protein level in Taiwanese adults: a cross-sectional study. J Clin Sleep Med 2014;10(7):743-749.http://dx.doi.org/10.5664/jcsm.3862 S C I E N T I F I C I N V E S T I G A T I O N SC -reactive protein is secreted by the liver in response to acute infl ammation and infection.1 The high-sensitivity C-reactive protein (hs-CRP) assay has low detection limits, and good performance for apparently healthy subjects.2 Elevated hs-CRP levels have been associated with infl ammation, aging, cancer, adverse outcomes of angina pectoris, coronary artery disease, adverse outcomes of chronic obstructive pulmonary disease, stroke, and increased risk of mortality. [3][4][5][6][7][8][9][10] In addition, elevated hs-CRP has been shown to be a stronger predictor of cardiovascular disease than low-density lipoprotein cholesterol.11 A recent study of more than 4,000 subjects followed for six years revealed that elevated hs-CRP was associated with type 2 diabetes. 12Another study with a follow-up of 11 years also demonstrated the same association of hs-CRP with diabetes.13 As expected, patients with lower glycosylated hemoglobin (A1C) levels were found to have signifi cantly lower hs-CRP levels.14 In recent years it has been shown that sleep duration might affect health in a number of ways, such as its associations with insulin resistance, diabetes, hyperleptinemia, heart disease, and mortality.15-17 Specifi cally, sho...

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Six-Year Change in High-Sensitivity Cardiac Troponin T and Risk of Subsequent Coronary Heart Disease, Heart Failure, and Death

et al. 2016

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Importance High-sensitivity cardiac troponin-T (hs-cTnT) is a biomarker of cardiovascular risk and could be approved in the US for clinical use soon. However, data linking long-term temporal change in hs-cTnT to outcomes are limited, particularly in primary prevention settings. Objective To examine the association of 6-year change in hs-cTnT with incident coronary heart disease (CHD), heart failure (HF; further sub-classified into reduced [HFrEF] and preserved ejection-fraction [HFpEF]), and all-cause mortality. Design The Atherosclerosis Risk in Communities (ARIC) prospective observational cohort. Setting General community US study with biracial representation. Participants 8,838 participants (mean age 56 years, 59% female, 21% Black), initially free of CHD and HF, who had hs-cTnT measured twice, 6 years apart. Main Outcome and Measures Risk factor and temporal hs-cTnT data were collected. Using Cox regression, we examined the association of hs-cTnT change with subsequent CHD, HF, and death over a maximum of 16 years. Improvement in discrimination was determined by Harrell’s C-statistic. Results There were 1,157 CHD events, 965 HF events, and 1,813 deaths overall. Incident detectable hs-cTnT (baseline<5ng/L, follow-up≥5ng/L) was independently associated with subsequent CHD (HR 1.4, 95%CI 1.2–1.6), HF (HR 2.0, 95%CI 1.6–2.4) and death (HR 1.5, 95%CI 1.3–1.7), relative to hs-cTnT <5ng/L at both visits. In addition, HRs as high as 4 for CHD and death and 8 for HF were recorded among subjects with the most marked hs-cTnT increases (e.g. baseline<5ng/L, follow-up≥14ng/L). Risk for subsequent outcomes was lower among those with relative hs-cTnT reductions >50% from baseline. Furthermore, information on hs-cTnT change improved discrimination for HF and death when added to a model that included traditional risk-factors, NT-proBNP and baseline hs-cTnT. Among subjects with adjudicated HF hospitalizations, hs-cTnT change appeared to be similarly associated with both HFrEF and HFpEF. Conclusions and Relevance Temporal increases in hs-cTnT, suggestive of progressive myocardial damage, are independently associated with incident CHD, death and, above all, with heart failure. Serial determination of hs-cTnT trajectory adds clinically relevant information to baseline testing and may be useful in prognostic assessments and in targeting prevention strategies to high-risk individuals, especially among persons with Stage A or B heart failure.

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

Cited by 72 publications

References 51 publications

Application and Interpretation of High-Sensitivity Cardiac Troponin Assays in Patients With Acute Ischemic Stroke

Application and Interpretation of High-Sensitivity Cardiac Troponin Assays in Patients With Acute Ischemic Stroke

Short Duration of Sleep Is Associated with Elevated High-Sensitivity C-Reactive Protein Level in Taiwanese Adults: A Cross-Sectional Study

Six-Year Change in High-Sensitivity Cardiac Troponin T and Risk of Subsequent Coronary Heart Disease, Heart Failure, and Death

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