Department of Cardiology, Hospital Santos Reyes Aranda de Duero Burgos, Spain.
Department of Cardiology, Hospital Santos Reyes Aranda de Duero Burgos, Spain.
Am J Med. 2019 May;132(5):631-638. doi: 10.1016/j.amjmed.2018.11.035. Epub 2018 Dec 15.
Prognostic value of high-sensitivity cardiac troponin T (hs-cTnT) assays have been assessed in selected populations in different studies and in registries of members of the general population with low cardiovascular risk. The aim of this study was to determine the prognostic value of hs-cTnT in an asymptomatic very-high cardiovascular risk Spanish population.
From a previous prospective cohort of the TUSARC (troponina T UltraSensible en pacientes Asintomáticos de alto Riesgo Cardiovascular) registry, follow-up was conducted in 602 patients (93.18%). The association of high hs-cTnT (≥99th percentile value) and incidence of primary event was studied. A primary event was defined as a combined major cardiovascular event (incidence of cardiovascular death, decompensated heart failure, non-fatal cerebrovascular event, non-fatal myocardial infarction, or coronary revascularization). The association between high hs-cTnT and incidence of secondary events was studied as well.
In patients with high hs-cTnT, the incidence of primary event during follow-up was significantly higher (18.30% vs 3.67% P < .001): heart failure (6.25% vs 0.73% P < .001), cardiovascular death (7.29% vs 0.00% P < .001), and death from any cause (7.81% vs 0.98% P < .001).
In an asymptomatic very-high cardiovascular risk Spanish population, elevated hs-cTnT was significantly associated with incident major cardiovascular combined end point and incidence of heart failure, cardiovascular death, and death from any cause.
在不同的研究和一般人群心血管低危成员的注册研究中,已经评估了高敏心肌肌钙蛋白 T(hs-cTnT)检测对预后的价值。本研究的目的是确定 hs-cTnT 在西班牙无症状极高心血管风险人群中的预后价值。
从之前的 TUSARC(超高心血管风险无症状患者的超敏肌钙蛋白 T)注册前瞻性队列中,对 602 例患者(93.18%)进行了随访。研究了高 hs-cTnT(≥99 百分位值)与主要事件发生率之间的关系。主要事件定义为复合主要心血管事件(心血管死亡、心力衰竭失代偿、非致命性脑血管事件、非致命性心肌梗死或冠状动脉血运重建的发生率)。还研究了高 hs-cTnT 与次要事件发生率之间的关系。
在 hs-cTnT 升高的患者中,随访期间主要事件的发生率明显较高(18.30% vs 3.67% P <.001):心力衰竭(6.25% vs 0.73% P <.001)、心血管死亡(7.29% vs 0.00% P <.001)和任何原因死亡(7.81% vs 0.98% P <.001)。
在西班牙无症状极高心血管风险人群中,升高的 hs-cTnT 与主要心血管复合终点以及心力衰竭、心血管死亡和任何原因死亡的发生率显著相关。