High-sensitivity troponin I and amino-terminal pro-B-type natriuretic peptide predict heart failure and mortality in the general population

Paul M. McKie, Omar F. AbouEzzeddine, Christopher G. Scott, Ramila Mehta, Richard J. Rodeheffer, Margaret M. Redfield, John C. Burnett, Allan S. Jaffe

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

INTRODUCTION: High-sensitivity cardiac troponin assays have potent prognostic value in stable cardiovascular disease cohorts. Our objective was to assess the prognostic utility of a novel cardiac troponin I (cTnI) high-sensitivity assay, independently and in combination with amino-terminal pro-B-type natriuretic peptide (NT-proBNP), for the future development of heart failure and mortality in the general community. METHODS: A well-characterized community-based cohort of 2042 participants underwent clinical assessment and echocardiographic evaluation. Baseline measurements of cTnI with a high-sensitivity assay and NT-proBNP were obtained in 1843 individuals. Participants were followed for new-onset heart failure and mortality with median (25th, 75th percentile) follow-up of 10.7 (7.9, 11.6) and 12.1 (10.4, 13.0) years, respectively. RESULTS: When measured with a high-sensitivity assay, cTnI greater than the sex-specific 80th percentile was independently predictive of heart failure [hazard ratio 2.56 (95% confidence interval 1.88-3.50), P < 0.001] and mortality [1.91(1.49-2.46), P < 0.001] beyond conventional risk factors in this community-based cohort, with significant increases in the net reclassification improvement for heart failure. The prognostic utility of cTnI measured with a high-sensitivity assay goes beyond NT-proBNP, yet our data suggest that these 2 assays are complementary and most beneficial when evaluated together in identifying at-risk individuals in the community. CONCLUSIONS: Our findings lay the foundation for prospective studies aimed at identification of individuals at high risk by use of a multimarker approach, followed by aggressive prevention strategies to prevent subsequent heart failure.

Original languageEnglish (US)
Pages (from-to)1225-1233
Number of pages9
JournalClinical chemistry
Volume60
Issue number9
DOIs
StatePublished - Sep 2014

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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