Cardiac Biomarker Increase Associated with Higher Risk of Heart Disease

Data analysis was performed from October 28, 2014, to March 9, 2016.

The first hs-cTnT level was measured in stored serum samples from visit two in 2012-2013 using a sandwich immunoassay method with a Roche Elecsys 2010 Analyzer (Roche Diagnostics, Indianapolis, IN, USA). The second hs-cTnT level was measured in stored supernatant plasma samples from visit four in 2010 using an electrochemiluminescence immunoassay implemented on a Roche Cobas e411 analyzer. Other tests included highly sensitive C-reactive protein, serum creatinine, and N-terminal pro–brain natriuretic peptide (NT-proBN).

Of the 8,838 participants (mean age, 56 years; 5,215 female (59.0%); 1,891 black (21.4%) there were 1,157 CHD events, 965 HF events, and 1,813 deaths overall. Incident detectable hs-cTnT, baseline, less than 0.005 ng/mL; follow-up, greater than 0.005 ng/mL, was independently associated with subsequent CHD, HF and death relative to an hs-cTnT level less than 0.005 ng/mL at both visits. Individuals with the most marked hs-cTnT increases, those whose baseline was less than 0.005 ng/mL but the follow-up was equal to or greater than 0.014 ng/mL, had significantly increased risks for CHD, HF and death.

The authors concluded that temporal increases in hs-cTnT, is suggestive of progressive myocardial damage, and are independently associated with incident CHD, death, and, above all, HF. Serial determination of hs-cTnT trajectory adds clinically relevant information to baseline testing and may be useful in prognostic assessments and the targeting of prevention strategies to high-risk individuals, especially among persons with stage A or B HF. The study was published on June 8, 2016, in the journal JAMA Cardiology.

Related Links:
Johns Hopkins Bloomberg School of Public Health
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