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

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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)

Abstract

Objective: To evaluate associations of high-sensitivity cardiac troponin-T (cTnT) with cardiovascular disease (CVD), heart failure (HF), and mortality in community-dwelling women and men. Participants and Methods: A total of 8226 adults from the Prevention of Renal and Vascular End-stage Disease (PREVEND) cohort (1997–1998) were enrolled in a prospective observational study (mean age: 49 years; 50.2% women). Sex-specific associations of cTnT levels with future clinical outcomes were evaluated using adjusted Cox-regression models. Results: Measurable cTnT levels (≥3 ng/L) were detected in 1102 women (26.7%) and in 2396 men (58.5%). Baseline cTnT levels were associated with a greater risk of developing CVD in women than men [Hazard ratio (HRwomen), 1.48 per unit increase in log2-cTnT; 95% CI, 1.21 to 1.81 vs HRmen, 1.20; 95% CI, 1.07 to 1.35; Pinteraction<.001]. Similar sex-related differences were observed for HF (Pinteraction= .005) and mortality (Pinteraction= .008). Further, compared with referent category (cTnT <3 ng/L), women with cTnT levels greater than or equal to 6 ng/L had a significantly increased risk for CVD (HR, 2.30; 95% CI, 1.45 to 3.64), HF (HR, 2.86; 95% CI, 1.41 to 5.80), and mortality (HR, 2.65; 95% CI, 1.52 to 4.61), whereas men with cTnT levels greater than or equal to 6 ng/L had a significantly increased risk only for CVD (HR, 1.51; 95% CI, 1.07 to 2.13). Conclusion: Baseline cTnT levels were associated with future CVD, HF, and mortality in both sexes, and these associations were stronger in women. Future studies are needed to determine the value of cTnT in early diagnosis of CVD, particularly in women.

Original languageEnglish
Pages (from-to)1158-1168
Number of pages11
JournalMayo Clinic Proceedings
Volume95
Issue number6
DOIs
Publication statusPublished - Jun 2020
Externally publishedYes

Bibliographical note

Funding Information:
Potential Competing Interests: This work was supported by the Netherlands Heart Foundation (CVON SHE-PREDICTS-HF, grant 2017-21 to Drs de Boer, van Empel, Heymans, and Schroen). Further support is acknowledged from the Netherlands Heart Foundation (CVON DOSIS, grant 2014-40 to Dr de Boer, and CVON RED-CVD, grant 2017-11 to Dr de Boer); and the Innovational Research Incentives Scheme program of the Netherlands Organization for Scientific Research ( NWO VIDI, grant 917.13.350 to Dr de Boer), and the European Research Council Grant (ERC CoG 818715, SECRETE-HF) to Dr de Boer. The PREVEND study was financially supported by grant E.013 of the Dutch Kidney Foundation . The research leading to these results has received funding from the European Union Commission’s Seventh Framework programme under grant agreement N° 305507 (HOMAGE), N° 602904 (FIBROTARGETS). The UMCG, which employs several of the authors has received research grants and/or fees from AstraZeneca , Abbott , Bristol-Myers Squibb , Novartis , Novo Nordisk and Roche . Dr de Boer has received speaker fees from Abbott, AstraZeneca, Novartis, and Roche. The remaining authors report no conflicts of interest.

Funding Information:
Potential Competing Interests: This work was supported by the Netherlands Heart Foundation (CVON SHE-PREDICTS-HF, grant 2017-21 to Drs de Boer, van Empel, Heymans, and Schroen). Further support is acknowledged from the Netherlands Heart Foundation (CVON DOSIS, grant 2014-40 to Dr de Boer, and CVON RED-CVD, grant 2017-11 to Dr de Boer); and the Innovational Research Incentives Scheme program of the Netherlands Organization for Scientific Research (NWO VIDI, grant 917.13.350 to Dr de Boer), and the European Research Council Grant (ERC CoG 818715, SECRETE-HF) to Dr de Boer. The PREVEND study was financially supported by grant E.013 of the Dutch Kidney Foundation. The research leading to these results has received funding from the European Union Commission's Seventh Framework programme under grant agreement N° 305507 (HOMAGE), N° 602904 (FIBROTARGETS). The UMCG, which employs several of the authors has received research grants and/or fees from AstraZeneca, Abbott, Bristol-Myers Squibb, Novartis, Novo Nordisk and Roche. Dr de Boer has received speaker fees from Abbott, AstraZeneca, Novartis, and Roche. The remaining authors report no conflicts of interest.

Publisher Copyright:
© 2020 Mayo Foundation for Medical Education and Research

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