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Dokumenttyp:
Article; Journal Article
Autor(en):
Börschel, Christin S; Geelhoed, Bastiaan; Niiranen, Teemu; Camen, Stephan; Donati, Maria Benedetta; Havulinna, Aki S; Gianfagna, Francesco; Palosaari, Tarja; Jousilahti, Pekka; Kontto, Jukka; Vartiainen, Erkki; Ojeda, Francisco M; den Ruijter, Hester M; Costanzo, Simona; de Gaetano, Giovanni; Di Castelnuovo, Augusto; Linneberg, Allan; Vishram-Nielsen, Julie K; Løchen, Maja-Lisa; Koenig, Wolfgang; Jørgensen, Torben; Kuulasmaa, Kari; Blankenberg, Stefan; Iacoviello, Licia; Zeller, Tanja; Söderberg...     »
Titel:
Risk prediction of atrial fibrillation and its complications in the community using hs troponin I.
Abstract:
AIMS: Atrial fibrillation (AF) is becoming increasingly common. Traditional cardiovascular risk factors (CVRF) do not explain all AF cases. Blood-based biomarkers reflecting cardiac injury such as high-sensitivity troponin I (hsTnI) may help close this gap. METHODS: We investigated the predictive ability of hsTnI for incident AF in 45,298 participants (median age 51.4 years, 45.0% men) across European community cohorts in comparison to CVRF and established biomarkers (C-reactive protein, N-terminal pro B-type natriuretic peptide). RESULTS: During a median follow-up of 7.7 years, 1734 (3.8%) participants developed AF. Those in the highest hsTnI quarter (≥4.2 ng/L) had a 3.91-fold (95% confidence interval (CI) 3.30, 4.63; p < .01) risk for developing AF compared to the lowest quarter (<1.4 ng/L). In multivariable-adjusted Cox proportional hazards models a statistically significant association was seen between hsTnI and AF (hazard ratio (HR) per 1 standard deviation (SD) increase in log10(hsTnI) 1.08; 95% CI 1.01, 1.16; p = .03). Inclusion of hsTnI did improve model discrimination (C-index CVRF 0.811 vs. C-index CVRF and hsTnI 0.813; p < .01). Higher hsTnI concentrations were associated with heart failure (HR per SD 1.37; 95% CI 1.12, 1.68; p < .01) and overall mortality (HR per SD 1.24; 95% CI 1.09, 1.41; p < .01). CONCLUSION: hsTnI as a biomarker of myocardial injury does not improve prediction of AF incidence beyond classical CVRF and NT-proBNP. However, it is associated with the AF-related disease heart failure and mortality likely reflecting underlying subclinical cardiovascular impairment.
Zeitschriftentitel:
Eur J Clin Invest
Jahr:
2023
Band / Volume:
53
Heft / Issue:
5
Volltext / DOI:
doi:10.1111/eci.13950
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/36602448
Print-ISSN:
0014-2972
TUM Einrichtung:
273; Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)
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