Department of Cardiology 670, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Heart. 2013 Apr;99(8):528-33. doi: 10.1136/heartjnl-2012-302829. Epub 2013 Jan 12.
To assess the association between baseline levels of highly sensitive cardiac troponin T (hs-cTnT) and long-term mortality in perimenopausal women of the general community using a gender specific 99th percentile reference limit.
Nested case control.
The present study was conducted within the Eindhoven Perimenopausal Osteoporosis Study which is a large prospective cohort of 8503 community-derived women of the city of Eindhoven, The Netherlands.
Cases were defined as Eindhoven Perimenopausal Osteoporosis Study participants who provided an adequate baseline blood sample and subsequently experienced death during follow-up between 1994 and 2003. In total, 123 cases were identified. For each case two matched controls were selected using age, body mass index and hypertension as matching factors. The gender specific 99th percentile reference limit determined in the 246 controls was 8.0 ng/l.
All cause mortality.
Hs-cTnT was significantly higher in the cases: 3.0 ng/l versus 2.3 ng/l (p=0.04). After adjustment for matching and clinical risk factors, each 1 SD increase of the level of hs-cTnT was significantly associated with mortality (OR 1.3, 95% CI 1.1 to 1.7, p=0.018). With amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in the multivariable model as a continuous variable the association of hs-cTnT with mortality was lost. With both hs-cTnT and NT-proBNP as dichotomous variables, the gender specific 99th percentile reference limit (8.0 ng/l) was associated with mortality, independent of NT-proBNP (OR 3.7, 95% CI 1.0 to 13.2, p=0.048).
In this study of community-derived perimenopausal women, hs-cTnT was associated with long-term mortality, independent of clinical risk factors. With the use of easily applicable cut-off levels, the gender specific reference limit of hs-cTnT had a prognostic impact that was independent of NT-proBNP.
使用特定于性别的 99 百分位参考限值，评估基线高敏心肌肌钙蛋白 T（hs-cTnT）水平与绝经期前妇女长期死亡率之间的关系。
巢式病例对照研究。
本研究在埃因霍温绝经后骨质疏松症研究中进行，该研究是一项大型前瞻性队列研究，纳入了荷兰埃因霍温市的 8503 名社区女性。
病例定义为在 1994 年至 2003 年期间提供了充足的基线血样，且随访期间发生死亡的埃因霍温绝经后骨质疏松症研究参与者。共确定了 123 例病例。对于每例病例，使用年龄、体重指数和高血压作为匹配因素选择 2 例匹配对照。在 246 例对照中确定的特定于性别的 99 百分位参考限值为 8.0ng/l。
全因死亡率。
病例组 hs-cTnT 显著升高：3.0ng/l 比 2.3ng/l（p=0.04）。在校正匹配因素和临床危险因素后，hs-cTnT 水平每增加 1 个标准差与死亡率显著相关（OR 1.3，95%CI 1.1 至 1.7，p=0.018）。在多变量模型中使用氨基末端 pro-B 型利钠肽（NT-proBNP）作为连续变量时，hs-cTnT 与死亡率的相关性丧失。将 hs-cTnT 和 NT-proBNP 均作为二分类变量，特定于性别的 99 百分位参考限值（8.0ng/l）与死亡率相关，且独立于 NT-proBNP（OR 3.7，95%CI 1.0 至 13.2，p=0.048）。
在这项针对社区绝经期前女性的研究中，hs-cTnT 与长期死亡率相关，独立于临床危险因素。使用易于应用的截断值，hs-cTnT 的特定于性别的参考限值具有独立于 NT-proBNP 的预后影响。
