Academic Journal
Premorbid levels of high-sensitivity cardiac troponin T and natriuretic peptide and prognosis after incident myocardial infarction
| Title: | Premorbid levels of high-sensitivity cardiac troponin T and natriuretic peptide and prognosis after incident myocardial infarction |
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| Authors: | Mok, Y, Sang, Y, Ballew, S.H, Hoogeveen, R.C, Ballantyne, C.M, Rosamond, W, Coresh, J, Selvin, E, Matsushita, K |
| Source: | American Heart Journal, 216 |
| Publisher Information: | Mosby Inc. |
| Publication Year: | 2019 |
| Collection: | Carolina Digital Repository (UNC - University of North Carolina) |
| Subject Terms: | biological marker, Incidence, clinical trial, risk assessment, aged, Female, systolic blood pressure, Natriuretic Peptide, Brain, creatinine blood level, antihypertensive agent, peripheral occlusive artery disease, amino terminal pro brain natriuretic peptide, middle aged, blood, ICD-9, multicenter study, Humans, recurrent disease, survival analysis, brain natriuretic peptide, Cohort Studies, Kaplan-Meier Estimate, male, heart infarction, diabetic patient, cardiovascular mortality, Myocardial Infarction, predictive value, asymptomatic disease |
| Description: | High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) at the time of myocardial infarction (MI) are strong predictors of prognosis. However, whether their premorbid (before MI occurrence) levels are associated with prognosis after incident MI is unknown. Methods: In 1,054 participants from the Atherosclerosis Risk in Communities Study with incident MI, we evaluated premorbid levels of hs-cTnT and NT-proBNP measured on median 5.8 (interquartile interval 3.0-11.5 [mean 5.5]) years prior to incident MI and their associations with subsequent composite and individual outcomes of all-cause mortality, cardiovascular mortality, recurrent MI, heart failure, and stroke. Results: During a median follow-up of 3.0 years after MI, 801 participants developed the composite outcome. Both hs-cTnT and NT-proBNP were independently associated with the composite outcome after incident MI. Among individual outcomes, all-cause mortality, cardiovascular mortality, and heart failure showed significant associations with both cardiac markers. Overall, NT-proBNP demonstrated a more evident relationship than hs-cTnT. Indeed, the addition of premorbid NT-proBNP alone, but not hs-cTnT alone, to conventional predictors at incident MI significantly improved risk prediction of the composite outcome after incident MI (∆c-statistic 0.013 [95% CI 0.005-0.022] from 0.691 with conventional predictors). Conclusions: Premorbid levels of hs-cTnT and NT-proBNP assessed on average 6 years prior to incident MI were associated with adverse outcomes after incident MI. These results further highlight the importance of cardiac health at an earlier stage of life. |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | https://cdr.lib.unc.edu/downloads/fx719x94k?file=thumbnail; https://cdr.lib.unc.edu/downloads/fx719x94k |
| DOI: | 10.17615/jx2w-mv45 |
| Availability: | https://doi.org/10.17615/jx2w-mv45 https://cdr.lib.unc.edu/downloads/fx719x94k?file=thumbnail https://cdr.lib.unc.edu/downloads/fx719x94k |
| Accession Number: | edsbas.A69B8E3D |
| Database: | BASE |
| DOI: | 10.17615/jx2w-mv45 |
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