Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.
Am Heart J. 2010 Jun;159(6):972-8. doi: 10.1016/j.ahj.2010.02.036.
A slight elevation of cardiac troponin T (TnT) levels in the circulating blood can be detected by the recently developed, high-sensitivity TnT (hsTnT) assay. However, it remains unclear whether a slight elevation of hsTnT is associated with an increased cardiovascular risk in subjects without overt cardiovascular disease (CVD).
The serum hsTnT levels were measured in a work site-based population of 1,072 middle-aged males (mean age 44 years) without any history or presence of CVD. The lower detection limit of the hsTnT assay used in the present study was 0.002 ng/mL. The association of the hsTnT levels with cardiovascular risk factors and the predicted CVD risk, as determined by the Framingham CVD risk prediction score, were examined.
Detectable hsTnT levels were seen in 867 subjects (80.9%). The highest value of the hsTnT was 0.020 ng/mL. Among various cardiovascular risk factors, age, blood pressure, estimated glomerular filtration rate, current smoking, and left ventricular hypertrophy were independent determinants of hsTnT levels. The odds ratio for a high predicted CVD risk (10-year risk > or =20%) in the highest tertile of hsTnT (> or =0.005 ng/mL) in comparison to the lowest tertile (< or =0.002 ng/mL) was 3.98 (95% CI 1.72-9.24, P = .001) after adjusting for multiple potential confounders.
The present study showed the hsTnT levels to be significantly associated with several cardiovascular risk factors and the predicted CVD risk in middle-aged men without overt CVD, thus suggesting the usefulness of measuring hsTnT to identify high-risk subjects in the primary prevention of CVD.
最近开发的高敏肌钙蛋白 T（hsTnT）检测方法可以检测到循环血液中心肌肌钙蛋白 T（TnT）水平的轻微升高。然而，hsTnT 的轻微升高是否与无明显心血管疾病（CVD）的受试者心血管风险增加有关尚不清楚。
在一个基于工作场所的 1072 名中年男性（平均年龄 44 岁）人群中测量了血清 hsTnT 水平，这些人没有任何 CVD 病史或表现。本研究中使用的 hsTnT 检测方法的最低检测限为 0.002ng/ml。检查了 hsTnT 水平与心血管危险因素以及Framingham CVD 风险预测评分确定的预测 CVD 风险之间的关系。
在 867 名受试者（80.9%）中检测到可检测的 hsTnT 水平。hsTnT 的最高值为 0.020ng/ml。在各种心血管危险因素中，年龄、血压、估计肾小球滤过率、当前吸烟和左心室肥厚是 hsTnT 水平的独立决定因素。与最低三分位（<0.002ng/ml）相比，hsTnT 最高三分位（>0.005ng/ml）的受试者预测 CVD 风险（10 年风险≥20%）的比值比为 3.98（95%CI 1.72-9.24，P=0.001），校正了多个潜在混杂因素后。
本研究表明，hsTnT 水平与中年无明显 CVD 男性的多个心血管危险因素和预测 CVD 风险显著相关，提示测量 hsTnT 有助于识别 CVD 一级预防的高危人群。
