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日本老年人群中高敏心肌肌钙蛋白T水平与卒中发病的关联:来自东北医学大数据库社区队列研究的结果

Association between high-sensitivity cardiac troponin T levels and incident stroke in the elderly Japanese population: Results from the Tohoku Medical Megabank Community-based Cohort Study.

作者信息

Kobayashi Takamasa, Nasu Takahito, Satoh Mamoru, Kotozaki Yuka, Tanno Kozo, Asahi Koichi, Ohmomo Hideki, Shimizu Atsushi, Omama Shinichi, Kikuchi Hiroto, Taguchi Satoru, Morino Yoshihiro, Sobue Kenji, Sasaki Makoto

机构信息

Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Japan.

Department of Biomedical Information Analysis, Institute for Biomedical Sciences, Iwate Medical University, Japan.

出版信息

Am Heart J Plus. 2022 Sep 28;22:100212. doi: 10.1016/j.ahjo.2022.100212. eCollection 2022 Oct.

Abstract

Elevated levels of circulating high-sensitivity cardiac troponin T (hs-cTnT) are associated with cardiovascular disease. This study aimed to examine whether hs-cTnT levels are associated with incident stroke in the elderly population. The Iwate Tohoku Medical Megabank Organization pooled participant data for a community-based cohort study (n = 15,063, 69.6 ± 3.4 years), with a mean follow-up period of 5.23 years for all-cause death and incident stroke. The follow-up revealed 316 incident strokes, including atherothrombotic (n = 98), cardioembolic (n = 54), lacunar (n = 63), hemorrhagic (n = 101), and 178 all-cause deaths. Participants were classified into quartiles according to hs-cTnT levels (Q1 ≦ 4 ng/L, Q2: 5-6 ng/L, Q3: 7-9 ng/L, and Q4 > 9 ng/L). After adjusting for sex, age, smoking, drinking, systolic blood pressure, estimated glomerular filtration rate, N-terminal pro-brain natriuretic peptide, hemoglobin A1c, and lipid profile, a Cox proportional hazard model showed that higher hs-cTnT levels were associated with ischemic stroke (Q1 vs. Q4, hazard ratio [HR] = 2.24, 95 % confidence interval [CI] = 1.12-4.51, p = 0.023). The incident of total stroke was not associated with hs-cTnT levels (Q1 vs. Q4, HR 1.39, 95 % CI = 0.89-1.74, p = 0.145). Numerical differences were highest regarding incident lacunar stroke subtypes; however, this association was not statistically significant. Higher hs-cTnT concentrations were associated with ischemic stroke in the elderly Japanese population.

摘要

循环高敏心肌肌钙蛋白T(hs-cTnT)水平升高与心血管疾病相关。本研究旨在探讨hs-cTnT水平是否与老年人群的卒中发病有关。岩手东北医学大银行组织汇总了一项基于社区的队列研究的参与者数据(n = 15,063,年龄69.6±3.4岁),全因死亡和卒中发病的平均随访期为5.23年。随访发现316例卒中发病,包括动脉粥样硬化血栓形成性(n = 98)、心源性栓塞性(n = 54)、腔隙性(n = 63)、出血性(n = 101),以及178例全因死亡。参与者根据hs-cTnT水平分为四分位数(Q1≤4 ng/L,Q2:5 - 6 ng/L,Q3:7 - 9 ng/L,Q4>9 ng/L)。在调整性别、年龄、吸烟、饮酒、收缩压、估计肾小球滤过率、N末端脑钠肽前体、糖化血红蛋白和血脂谱后,Cox比例风险模型显示,较高的hs-cTnT水平与缺血性卒中相关(Q1与Q4相比,风险比[HR]=2.24,95%置信区间[CI]=1.12 - 4.51,p = 0.023)。总卒中发病与hs-cTnT水平无关(Q1与Q4相比,HR 1.39,95%CI = 0.89 - 1.74,p = 0.145)。腔隙性卒中亚型发病的数值差异最大;然而,这种关联无统计学意义。较高的hs-cTnT浓度与日本老年人群的缺血性卒中相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c464/10978419/443d58e254bd/gr1.jpg

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