Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Division for Biochemistry of Joint and Connective Tissue Diseases, Department of Orthopedics, Ulm University, Ulm, Germany.
PLoS One. 2020 Dec 2;15(12):e0242814. doi: 10.1371/journal.pone.0242814. eCollection 2020.
Osteoarthritis (OA) is associated with adverse cardio-metabolic features. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponins T and I (hs-cTnT and hs-cTnI) are well-characterized cardiac markers and provide prognostic information. The objective was to assess the association of cardiac biomarker concentrations with long-term mortality in subjects with OA. In a cohort of 679 OA subjects, undergoing hip or knee replacement during 1995/1996, cardiac biomarkers were measured and subjects were followed over 20 years. During a median follow-up of 18.4 years, 332 (48.9%) subjects died. Median of hs-cTnT, hs-cTnI, and NT-proBNP at baseline was 3.2 ng/L, 3.9 ng/L, and 96.8 ng/L. The top quartile of NT-proBNP was associated with increased risk of mortality (Hazard Ratio (HR) 1.79, 95% confidence interval (CI) 1.17-2.73) after adjustment for covariates including troponins (hs-cTnT HR 1.30 (95% CI 0.90-1.89), hs-cTnI HR 1.32 (95% CI 0.87-2.00) for top category). When biomarker associations were evaluated as continuous variables, only NT-proBNP (HR per log-unit increment 1.34, 95% CI 1.16-1.54) and hs-cTnI (HR 1.38, 95% CI 1.11-1.72) showed robust results. Elevated cardiac biomarker concentrations predicted an increased risk of long-term mortality and strongest for NT-proBNP and hs-cTnI. These results might help to identify subjects at risk and target preventive efforts early.
骨关节炎（OA）与不良的心脏代谢特征相关。氨基末端 B 型利钠肽原（NT-proBNP）和高敏肌钙蛋白 T 和 I（hs-cTnT 和 hs-cTnI）是特征明确的心脏标志物，可提供预后信息。本研究旨在评估心脏生物标志物浓度与 OA 患者长期死亡率的相关性。在 1995/1996 年接受髋关节或膝关节置换术的 679 例 OA 患者队列中，测量了心脏生物标志物，并对患者进行了 20 年以上的随访。在中位随访 18.4 年期间，332 例（48.9%）患者死亡。基线时 hs-cTnT、hs-cTnI 和 NT-proBNP 的中位数分别为 3.2ng/L、3.9ng/L 和 96.8ng/L。NT-proBNP 最高四分位数与死亡率增加相关（调整包括肌钙蛋白在内的混杂因素后，风险比（HR）为 1.79，95%置信区间（CI）为 1.17-2.73）（hs-cTnT HR 为 1.30（95%CI 为 0.90-1.89），hs-cTnI HR 为 1.32（95%CI 为 0.87-2.00））。当将生物标志物相关性评估为连续变量时，仅 NT-proBNP（每对数单位增加的 HR 为 1.34，95%CI 为 1.16-1.54）和 hs-cTnI（HR 为 1.38，95%CI 为 1.11-1.72）显示出稳健的结果。心脏生物标志物浓度升高预示着长期死亡率增加的风险增加，NT-proBNP 和 hs-cTnI 最强。这些结果可能有助于识别高危人群，并尽早进行预防性干预。
