University of Galway School of Medicine and National Institute for Prevention and Cardiovascular Health, Moyola Lane, Newcastle, Galway H91-FF68, Connacht, Ireland.
Johns Hopkins Hospital and Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
Eur Heart J. 2023 Jul 21;44(28):2595-2605. doi: 10.1093/eurheartj/ehad328.
Cardiac troponin T and I can be measured using a number of high-sensitivity (hs) assays. This study aimed to characterize correlations between four such assays and test their comparative associations with mortality.
Among adults without cardiovascular disease in the 1999-2004 National Health and Nutrition Examination Survey, hs-troponin T was measured using one assay (Roche) and hs-troponin I using three assays (Abbott, Siemens, and Ortho). Cox regression was used to estimate associations with all-cause and cardiovascular mortality. Pearson's correlation coefficients comparing concentrations from each assay ranged from 0.53 to 0.77. There were 2188 deaths (488 cardiovascular) among 9810 participants. Each hs-troponin assay [log-transformed, per 1 standard deviation (SD)] was independently associated with all-cause mortality: hazard ratio (HR) 1.20 [95% confidence interval (CI) 1.13-1.28] for Abbott hs-troponin I; HR 1.10 (95% CI 1.02-1.18) for Siemens hs-troponin I; HR 1.23 (95% CI 1.14-1.33) for Ortho hs-troponin I; and HR 1.31 (95% CI 1.21-1.42) for Roche hs-troponin T. Each hs-troponin assay was also independently associated with cardiovascular mortality (HR 1.44 to 1.65 per 1 SD). Associations of hs-troponin T and all-cause and cardiovascular mortality remained significant after adjusting for hs-troponin I. Furthermore, associations of hs-troponin I remained significant after mutually adjusting for hs-troponin I from the other individual assays: e.g. cardiovascular mortality HR 1.46 (95% CI 1.19-1.79) for Abbott after adjustment for the Siemens assay and HR 1.29 (95% CI 1.09-1.53) for Abbott after adjustment for the Ortho assay.
This study demonstrates only modest correlations between hs-troponin T and three hs-troponin I assays and that hs-troponin I assays can provide distinct risk information for mortality in the general population.
肌钙蛋白 T 和 I 可使用多种高敏（hs）检测方法进行测量。本研究旨在分析这 4 种检测方法间的相关性，并检验其与死亡率的比较相关性。
在 1999-2004 年全国健康和营养调查中，无心血管疾病的成年人使用罗氏公司的一种检测方法（hs-troponin T）和另外 3 种检测方法（Abbott、Siemens 和 Ortho 的 hs-troponin I）进行 hs-troponin I 检测。采用 Cox 回归分析评估与全因死亡率和心血管死亡率的相关性。每种检测方法检测浓度间的皮尔逊相关系数范围为 0.53 至 0.77。9810 名参与者中有 2188 人死亡（488 例心血管死亡）。每个 hs-troponin 检测[经对数转换，每 1 个标准差（SD）]均与全因死亡率独立相关：Abbott hs-troponin I 的危险比（HR）为 1.20（95%置信区间[CI]为 1.13-1.28）；Siemens hs-troponin I 的 HR 为 1.10（95% CI 为 1.02-1.18）；Ortho hs-troponin I 的 HR 为 1.23（95% CI 为 1.14-1.33）；罗氏 hs-troponin T 的 HR 为 1.31（95% CI 为 1.21-1.42）。每个 hs-troponin 检测与心血管死亡率也独立相关（每 1 SD 增加 1.44 至 1.65）。调整 hs-troponin I 后，hs-troponin T 与全因和心血管死亡率的相关性仍然显著。此外，在相互调整了其他单个检测方法的 hs-troponin I 后，hs-troponin I 的相关性仍然显著：例如，在调整 Siemens 检测方法后，Abbott hs-troponin I 的心血管死亡率 HR 为 1.46（95% CI 为 1.19-1.79）；在调整 Ortho 检测方法后，Abbott hs-troponin I 的 HR 为 1.29（95% CI 为 1.09-1.53）。
本研究表明，hs-troponin T 与 3 种 hs-troponin I 检测方法之间相关性仅为中等程度，hs-troponin I 检测方法可为一般人群的死亡率提供独特的风险信息。
