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

作者：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^*

来源：European Journal of Preventive Cardiology, 2017, 24(6): 628-638.

DOI：10.1177/2047487316683071

• Metabolic syndrome
• high-sensitive troponin T
• risk stratification
• heart failure
• coronary heart disease

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.

• 出版日期2017-4