Research Unit on Ageing, AGAPLESION Bethesda Clinic Ulm, Ulm, Germany.
Medical Faculty, Ulm University, Ulm, Germany.
Sci Rep. 2024 Nov 18;14(1):28412. doi: 10.1038/s41598-024-78641-7.
Elevated high-sensitivity cardiac troponin-T (hs-cTnT) is associated with mortality in older adults. However, little is known about the implications of changes over time. We investigated hs-cTnT 3-year change and its association with subsequent mortality in the Activity and Function in the Elderly Study. Participants with baseline and follow-up hs-cTnT < 5 ng/L built the reference group (G1 = 156). Five groups were defined among those with an increment over time: Undetectable at baseline: follow-up < 14 ng/L (G2 = 295), follow-up ≥ 14 ng/L (G3 = 24). Baseline 5 to <14 ng/L: follow-up < 14 ng/L (G4 = 101), follow-up ≥ 14 ng/L (G5 = 96). G6 included baseline and follow-up > 14 ng/L (n = 74). Cox-proportional hazards models evaluated the association with mortality adjusting for age, sex, education, cardiovascular disease, chronic kidney disease, number of medications, hs-CRP, and NT-proBNP. Among 745 participants (median age 75.9 years, 58.9% male) we observed 98 deaths (median follow-up 4.8 years). G1 had the lowest mortality rate (MR) (5.2 per 1000 person-years). The highest MR were observed by follow-up ≥ 14 ng/L: G3: 95.4 and G6: 100.4 per 1000 person-years, with an adjusted hazard ratio of 5.22 [95% CI 1.46, 18.65] and 3.40 [95% CI 1.02, 11.34], respectively. Hs-cTnT trajectories could help to identify older adults with a high mortality risk even after further adjustment including hs-CRP and NT-proBNP.
高敏心肌肌钙蛋白 T（hs-cTnT）升高与老年人死亡率相关。然而，关于随时间变化的影响知之甚少。我们研究了 hs-cTnT 3 年变化及其与随后的老年活动和功能研究中的死亡率的关系。具有基线和随访 hs-cTnT <5ng/L 的参与者构成参考组（G1=156）。在随时间增加的人群中定义了五个组：基线时不可检测：随访<14ng/L（G2=295），随访≥14ng/L（G3=24）。基线时 5-<14ng/L：随访<14ng/L（G4=101），随访≥14ng/L（G5=96）。G6 包括基线和随访>14ng/L（n=74）。Cox 比例风险模型通过调整年龄、性别、教育、心血管疾病、慢性肾脏病、药物数量、hs-CRP 和 NT-proBNP 评估与死亡率的相关性。在 745 名参与者（中位年龄 75.9 岁，58.9%为男性）中，我们观察到 98 例死亡（中位随访 4.8 年）。G1 的死亡率最低（5.2 人年）。随访时≥14ng/L 时观察到最高的 MR：G3：95.4 和 G6：100.4 人年，校正后的危险比分别为 5.22（95%CI 1.46，18.65）和 3.40（95%CI 1.02，11.34）。即使在包括 hs-CRP 和 NT-proBNP 在内的进一步调整后，hs-cTnT 轨迹仍可帮助识别死亡率较高的老年人。
