Association between high-sensitivity troponin T and cardiovascular risk in individuals with and without metabolic syndrome: The ARIC study. (April 2017)

• Record Type: Journal Article
• Authors: Pokharel, Yashashwi; Sun, Wensheng; Villareal, Dennis T; Selvin, Elizabeth; Virani, Salim S; Ndumele, Chiadi E; Hoogeveen, Ron C; Coresh, Josef; Boerwinkle, Eric; Butler, Kenneth R; Solomon, Scott D; Pankow, James S; Bozkurt, Biykem; Ballantyne, Christie M; Nambi, Vijay
• Is Part Of: European journal of preventive cardiology. Volume 24:Number 6(2017)
• Page Start: 628
• Page End: 638
• Publication Date: 2017-04
• Subjects: Metabolic syndrome -- high-sensitive troponin T -- risk stratification -- heart failure -- coronary heart disease; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Cardiac patients -- Rehabilitation -- Periodicals; 616.12
• DOI: 10.1177/2047487316683071
• Languages: English
• ISSNs: 2047-4873

Abstract

Background: Metabolic syndrome (MetS) is associated with increased risk for cardiovascular disease, but there is heterogeneity in this risk. We evaluated whether high-sensitivity troponin T (hs-cTnT), a marker associated with cardiovascular disease, can stratify risk in MetS. Methods: We evaluated associations between MetS (and groups with similar number of MetS components) and incident heart failure hospitalization, coronary heart disease, stroke and death using hs-cTnT categories after adjusting for risk factors/markers between 1996 and 2011 in 8204 individuals in the Atherosclerosis Risk In Communities study. Results: The mean age of the population was 63 years (56% women, 19% Blacks). hs-cTnT levels were higher with MetS and with increasing MetS components. In individuals with MetS, higher hs-cTnT levels were associated with increased hazard ratios for heart failure, coronary heart disease and death. Within each number of MetS components, higher hs-cTnT was associated with progressively higher heart failure, coronary heart disease and death hazards. The association was particularly strong for heart failure. With increasing hs-cTnT categories, the hazard ratios (95% confidence interval) for heart failure in individuals with MetS increased gradually from 1.68 (1.31–2.16) to 3.76 (2.69–5.26) ( p -trend < 0.001) compared with those with MetS and hs-cTnT < 5 ng/l; and respective hazard ratios with increasing hs-cTnT categories in those with all five MetS components ranged from 2.22 (1.17–4.21) to 4.23 (1.89–9.50) ( p -trend 0.004) compared with those with all five MetS components and hs-cTnT < 5 ng/l. However, mostly there were no significant interactions of hs-cTnT with MetS or its components. Conclusion: hs-cTnT is useful for identifying MetS patients with increased hazards for coronary heart disease, death and particularly heart failure.