Qu Qiang, Shi Yanping, Guo Qixin, Yue Xin, Chen Lu, Sun Jinyu, Chen Ziqi, Shi Jinjing, Cheang Iokfai, Zhu Xu, Yao Wenming, Gao Rongrong, Li Xinli, Zhou Yanli, Zhang Haifeng, Liao Shengen
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 26 Daoqian Street, Suzhou 215002, China.
Arch Gerontol Geriatr. 2024 Jan;116:105140. doi: 10.1016/j.archger.2023.105140. Epub 2023 Jul 31.
Current evidence on the association between high-sensitivity cardiac troponin T (hs-cTnT) levels and mortality in elderly sarcopenic patients is limited. This study aimed to investigate the association of serum hs-cTnT concentrations with all-cause and cardiovascular mortality in older adults with low lean mass (LLM) and without baseline cardiovascular disease.
This prospective cohort study included 369 older adults (representing 3.2 million people) from the National Health and Nutrition Examination Survey 1999-2004. Individuals were linked to national death records until 31 December 2019. The weighted Kaplan-Meier analysis, Cox proportional hazards models, restricted cubic spline models, stratified analysis, interaction analysis, and sensitivity analysis were performed to examine the association between hs-cTnT levels and mortality in older adults with LLM.
During 4697 person-years of follow-up (median duration, 14.6 years), 228 (65.6%) deaths were documented, including 56 (15.8%) deaths from cardiovascular disease. Individuals with a hs-cTnT level of ≥14 ng/L had 2.1- and 4.4-fold higher risks of all-cause and cardiovascular mortality, respectively. Compared with the lowest quartile, the fourth quartile of hs-cTnT levels was significantly associated with 3.1- and 6.4-fold higher risks of all-cause and cardiovascular mortality, respectively. Each one standard deviation increase in natural log-transformed hs-cTnT levels significantly and linearly increased the risks of all-cause and cardiovascular mortality by 39% and 61%, respectively. Stratified and sensitivity analyses confirmed the robustness of the association.
In this nationally representative cohort of US older adults with LLM, higher serum hs-cTnT concentrations were significantly associated with increased risks of all-cause and cardiovascular mortality.
目前关于高敏心肌肌钙蛋白T（hs-cTnT）水平与老年肌少症患者死亡率之间关联的证据有限。本研究旨在调查血清hs-cTnT浓度与低瘦体重（LLM）且无基线心血管疾病的老年人全因死亡率和心血管死亡率之间的关联。
这项前瞻性队列研究纳入了1999 - 2004年美国国家健康与营养检查调查中的369名老年人（代表320万人）。这些个体与国家死亡记录相链接，直至2019年12月31日。采用加权Kaplan-Meier分析、Cox比例风险模型、受限立方样条模型、分层分析、交互作用分析和敏感性分析，以检验hs-cTnT水平与LLM老年人死亡率之间的关联。
在4697人年的随访期间（中位持续时间为14.6年），记录了228例（65.6%）死亡，其中包括56例（15.8%）心血管疾病死亡。hs-cTnT水平≥14 ng/L的个体全因死亡率和心血管死亡率分别高出2.1倍和4.4倍。与最低四分位数相比，hs-cTnT水平的第四四分位数与全因死亡率和心血管死亡率分别高出3.1倍和6.4倍显著相关。自然对数转换后的hs-cTnT水平每增加一个标准差，全因死亡率和心血管死亡率的风险分别显著线性增加39%和61%。分层分析和敏感性分析证实了这种关联的稳健性。
在这个具有全国代表性的美国LLM老年人群队列中，较高的血清hs-cTnT浓度与全因死亡率和心血管死亡率风险增加显著相关。
