发布日期：2011 年 4 月
英文标题：Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the Atherosclerosis Risk in Communities Study.
作者：Saunders JT, Nambi V, de Lemos JA, Chambless LE, Virani SS, Boerwinkle E, Hoogeveen RC, Liu X, Astor BC, Mosley TH, Folsom AR, Heiss G, Coresh J, Ballantyne CM.
出处：Circulation. 2011 Apr 5;123(13):1367-76.
内容介绍：ARIC 研究 (纳入 9698 例基线时无冠状动脉心血管疾病、卒中，年龄 54-74 岁的普通参与者) 中发现，可检测到 hs-cTnT(≥ 0.003 μg/L) 者占 66.5%，hs-cTnT>0.014 μg/L 者占 7.4%。调整传统心血管危险因素、肾功能、高敏 C 反应蛋白水平、NT-proBNP 水平后，冠心病、死亡、心力衰竭住院的发生率等随 hs-cTnT 水平的增加而增高。hs-cTnT 水平最高组 (≥ 0.014LLg/L) 的冠心病、致死性冠心病、总死亡和心力衰竭的风险均明显增高。即在未患有冠状动脉心脏病/卒中的人群中，使用高敏感性的方法检测到 cTnT 与冠状动脉心脏病事件发生率、死亡率、因心衰住院相关。
摘要展示：
BACKGROUND: We evaluated whether cardiac troponin T (cTnT) measured with a new highlysensitive assay was associated with incident coronary heart disease (CHD), mortality, and hospitalization for heart failure (HF) in a general population of participants in the AtherosclerosisRisk in Communities (ARIC) Study.
METHODS AND RESULTS: Associations between increasing cTnT levels and CHD, mortality, and HF hospitalization were evaluated with Cox proportional hazards models adjusted for traditional CHD risk factors, kidney function, high-sensitivity C-reactive protein, and N-terminal pro-B-type natriuretic peptide in 9698 participants aged 54 to 74 years who at baseline were free from CHD and stroke (and HF in the HF analysis). Measurable cTnT levels (≥ 0.003 μg/L) were detected in 66.5% of individuals. In fully adjusted models, compared with participants with undetectable levels, those with cTnT levels in the highest category (≥ 0.014 μg/L; 7.4% of the ARIC population) had significantly increased risk for CHD (hazard ratio = 2.29; 95% confidence interval, 1.81 to 2.89), fatal CHD (hazard ratio = 7.59; 95% confidence interval, 3.78 to 15.25), total mortality (hazard ratio = 3.96; 95% confidence interval, 3.21 to 4.88), and HF (hazard ratio = 5.95; 95% confidence interval, 4.47 to 7.92). Even minimally elevated cTnT (≥ 0.003 μg/L) was associated with increasedrisk for mortality and HF (P<0.05). Adding cTnT to traditional risk factors improved risk prediction parameters; the improvements were similar to those with N-terminal pro-B-type natriuretic peptide and better than those with the addition of high-sensitivity C-reactive protein.
CONCLUSIONS: cTnT detectable with a highly sensitive assay was associated with incident CHD,mortality, and HF in individuals from a general population without known CHD/stroke.
