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无症状心血管高危患者的高敏肌钙蛋白T检测。TUSARC注册研究

High-sensitivity Troponin T Assay in Asymptomatic High Cardiovascular Risk Patients. The TUSARC Registry.

作者信息

Álvarez Isabel, Hernández Luis, García Héctor, Villamandos Vicente, López María Gracia, Palazuelos Molinero Jorge, Martín Raymondi Diego

机构信息

Medicina Familiar y Comunitaria, Hospital Santos Reyes, Aranda de Duero, Burgos, Spain.

Servicio de Medicina Interna, Hospital Santos Reyes, Aranda de Duero, Burgos, Spain.

出版信息

Rev Esp Cardiol (Engl Ed). 2017 Apr;70(4):261-266. doi: 10.1016/j.rec.2016.11.018. Epub 2016 Dec 22.

Abstract

INTRODUCTION AND OBJECTIVES

High-sensitivity troponin T assays (Hs-TnT) have been carried out in selected populations in clinical trials and in registries of the general population with low cardiovascular risk (CVR). The aim of this study was to determine the proportion of individuals with detectable Hs-TnT and the proportion of individuals with elevated Hs-TnT in a Spanish population of asymptomatic individuals with very high CVR, as well as the parameters associated with Hs-TnT elevation.

METHODS

The study included 690 patients. Hs-TnT detection and Hs-TnT elevation (≥99th percentile value), as well the association of elevated Hs-TnT and clinical, analytical, and treatment data were analyzed.

RESULTS

Hs-TnT was analyzed in 646 patients and was detected in 645. Elevated TnT was detected in 212 patients (32.9%). On multivariate analysis, elevated TnT was independently associated with male sex (OR, 2.81; 95%CI, 1.67-4.73; P < .001), older age (OR, 1.06; 95%CI, 1.04-1.09; P < .001), a higher body mass index (OR, 1.07; 95%CI, 1.02-1.12; P < .002), insulin therapy (OR, 1.99; 95%CI, 1.15-3.46; P = .01), history of heart failure (OR, 3.92; 95%CI, 1.24-12.39; P = .02), and estimated glomerular filtration rate calculated by CKD-EPI (OR, 0.96; 95%CI, 0.95-0.97; P < .001).

CONCLUSIONS

In a Spanish population of asymptomatic individuals at very high CVR, Hs-TnT was associated with older age, male sex, higher body mass index, insulin therapy, history of heart failure, and lower glomerular filtration rate.

摘要

引言与目的

高敏肌钙蛋白T检测(Hs-TnT)已在临床试验中的特定人群以及心血管风险(CVR)较低的普通人群登记研究中开展。本研究的目的是确定在西班牙具有极高CVR的无症状个体人群中可检测到Hs-TnT的个体比例以及Hs-TnT升高的个体比例,以及与Hs-TnT升高相关的参数。

方法

该研究纳入了690例患者。分析了Hs-TnT检测、Hs-TnT升高(≥第99百分位数)情况,以及Hs-TnT升高与临床、分析和治疗数据之间的关联。

结果

对646例患者进行了Hs-TnT分析,其中645例检测到Hs-TnT。212例患者(32.9%)检测到TnT升高。多因素分析显示,TnT升高与男性(比值比[OR],2.81;95%置信区间[CI],1.67 - 4.73;P <.001)、年龄较大(OR,1.06;95%CI,1.04 - 1.09;P <.001)、较高的体重指数(OR,1.07;95%CI,1.02 - 1.12;P <.002)、胰岛素治疗(OR,1.99;95%CI,1.15 - 3.46;P = 0.01)、心力衰竭病史(OR,3.92;95%CI,1.24 - 12.39;P = 0.02)以及根据慢性肾脏病流行病学合作公式(CKD-EPI)计算的估计肾小球滤过率(OR,0.96;95%CI,0.95 - 0.97;P <.001)独立相关。

结论

在西班牙具有极高CVR的无症状个体人群中,Hs-TnT与年龄较大、男性、较高的体重指数、胰岛素治疗、心力衰竭病史以及较低的肾小球滤过率相关。

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