Troponin I and T in relation to cardiac injury detected with electrocardiography in a population-based cohort - The Maastricht Study

Dorien M. Kimenai; Remy J. H. Martens; Jeroen P. Kooman; Coen D. A. Stehouwer; Frans E. S. Tan; Nicolaas C. Schaper; Pieter C. Dagnelie; Miranda T. Schram; Carla J. H. van der Kallen; Simone J. S. Sep; Jeroen D. E. van Suijlen; Abraham A. Kroon; Otto Bekers; Marja P. van Dieijen-Visser; Ronald M. A. Henry; Steven J. R. Meex

doi:10.1038/s41598-017-06978-3

Troponin I and T in relation to cardiac injury detected with electrocardiography in a population-based cohort - The Maastricht Study

Dorien M. Kimenai, Remy J. H. Martens, Jeroen P. Kooman, Coen D. A. Stehouwer, Frans E. S. Tan, Nicolaas C. Schaper, Pieter C. Dagnelie, Miranda T. Schram, Carla J. H. van der Kallen, Simone J. S. Sep, Jeroen D. E. van Suijlen, Abraham A. Kroon, Otto Bekers, Marja P. van Dieijen-Visser, Ronald M. A. Henry, Steven J. R. Meex^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Interest in high-sensitivity cardiac troponin I(hs-cTnI) and T(hs-cTnT) has expanded from acute cardiac care to cardiovascular disease(CVD) risk stratification. Whether hs-cTnI and hs-cTnT are interchangeable in the ambulant setting is largely unexplored. Cardiac injury is a mechanism that may underlie the associations between troponin levels and mortality in the general population. In the population-based Maastricht Study, we assessed the correlation and concordance between hs-cTnI and hs-cTnT. Multiple regression analyses were conducted to assess the association of hs-cTnI and hs-cTnT with electrocardiographic (ECG) changes indicative of cardiac abnormalities. In 3016 eligible individuals(mean age, 60 +/- 8 years; 50.6%, men) we found a modest correlation between hs-cTnI and hs-cTnT(r = 0.585). After multiple adjustment, the association with ECG changes indicative of cardiac abnormalities was similar for both hs-cTn assays(OR, hs-cTnI: 1.72,95% CI: 1.40-2.10; OR, hs-cTnT: 1.60,95% CI: 1.22-2.11). The concordance of dichotomized hs-cTnI and hs-cTnT was kappa =0.397 (>= sex-specific 75th percentile). Isolated high levels of hs-cTnI were associated with ECG changes indicative of cardiac abnormalities(OR: 1.93,95% CI: 1.01-3.68), whereas isolated high levels of hs-cTnT were not(OR: 1.07,95% CI: 0.49-2.31). In conclusion, there is a moderate correlation and limited concordance between hs-cTnI and hs-cTnT under non-acute conditions. These data suggest that associations of hs-cTnI and hs-cTnT with cardiac injury detected by ECG are driven by different mechanisms. This information may benefit future development of CVD risk stratification algorithms.

Original language	English
Article number	6610
Number of pages	9
Journal	Scientific Reports
Volume	7
Issue number	1
DOIs	https://doi.org/10.1038/s41598-017-06978-3
Publication status	Published - 26 Jul 2017

Keywords

GLOMERULAR-FILTRATION-RATE
HIGHLY SENSITIVE ASSAY
CARDIOVASCULAR RISK
GENERAL-POPULATION
COGNITIVE PERFORMANCE
HEALTHY POPULATION
PROGNOSTIC VALUE
MORTALITY
DISEASE
COMMUNITY

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Kimenai, D. M., Martens, R. J. H., Kooman, J. P., Stehouwer, C. D. A., Tan, F. E. S., Schaper, N. C., Dagnelie, P. C., Schram, M. T., van der Kallen, C. J. H., Sep, S. J. S., van Suijlen, J. D. E., Kroon, A. A., Bekers, O., van Dieijen-Visser, M. P., Henry, R. M. A., & Meex, S. J. R. (2017). Troponin I and T in relation to cardiac injury detected with electrocardiography in a population-based cohort - The Maastricht Study. Scientific Reports, 7(1), Article 6610. https://doi.org/10.1038/s41598-017-06978-3

@article{eb1d40af691a4a28a7c8b8829432848f,

title = "Troponin I and T in relation to cardiac injury detected with electrocardiography in a population-based cohort - The Maastricht Study",

abstract = "Interest in high-sensitivity cardiac troponin I(hs-cTnI) and T(hs-cTnT) has expanded from acute cardiac care to cardiovascular disease(CVD) risk stratification. Whether hs-cTnI and hs-cTnT are interchangeable in the ambulant setting is largely unexplored. Cardiac injury is a mechanism that may underlie the associations between troponin levels and mortality in the general population. In the population-based Maastricht Study, we assessed the correlation and concordance between hs-cTnI and hs-cTnT. Multiple regression analyses were conducted to assess the association of hs-cTnI and hs-cTnT with electrocardiographic (ECG) changes indicative of cardiac abnormalities. In 3016 eligible individuals(mean age, 60 +/- 8 years; 50.6%, men) we found a modest correlation between hs-cTnI and hs-cTnT(r = 0.585). After multiple adjustment, the association with ECG changes indicative of cardiac abnormalities was similar for both hs-cTn assays(OR, hs-cTnI: 1.72,95% CI: 1.40-2.10; OR, hs-cTnT: 1.60,95% CI: 1.22-2.11). The concordance of dichotomized hs-cTnI and hs-cTnT was kappa =0.397 (>= sex-specific 75th percentile). Isolated high levels of hs-cTnI were associated with ECG changes indicative of cardiac abnormalities(OR: 1.93,95% CI: 1.01-3.68), whereas isolated high levels of hs-cTnT were not(OR: 1.07,95% CI: 0.49-2.31). In conclusion, there is a moderate correlation and limited concordance between hs-cTnI and hs-cTnT under non-acute conditions. These data suggest that associations of hs-cTnI and hs-cTnT with cardiac injury detected by ECG are driven by different mechanisms. This information may benefit future development of CVD risk stratification algorithms.",

keywords = "GLOMERULAR-FILTRATION-RATE, HIGHLY SENSITIVE ASSAY, CARDIOVASCULAR RISK, GENERAL-POPULATION, COGNITIVE PERFORMANCE, HEALTHY POPULATION, PROGNOSTIC VALUE, MORTALITY, DISEASE, COMMUNITY",

author = "Kimenai, {Dorien M.} and Martens, {Remy J. H.} and Kooman, {Jeroen P.} and Stehouwer, {Coen D. A.} and Tan, {Frans E. S.} and Schaper, {Nicolaas C.} and Dagnelie, {Pieter C.} and Schram, {Miranda T.} and {van der Kallen}, {Carla J. H.} and Sep, {Simone J. S.} and {van Suijlen}, {Jeroen D. E.} and Kroon, {Abraham A.} and Otto Bekers and {van Dieijen-Visser}, {Marja P.} and Henry, {Ronald M. A.} and Meex, {Steven J. R.}",

year = "2017",

month = jul,

day = "26",

doi = "10.1038/s41598-017-06978-3",

language = "English",

volume = "7",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Publishing Group",

number = "1",

}

Kimenai, DM, Martens, RJH, Kooman, JP, Stehouwer, CDA, Tan, FES, Schaper, NC, Dagnelie, PC , Schram, MT , van der Kallen, CJH , Sep, SJS, van Suijlen, JDE, Kroon, AA , Bekers, O, van Dieijen-Visser, MP, Henry, RMA & Meex, SJR 2017, 'Troponin I and T in relation to cardiac injury detected with electrocardiography in a population-based cohort - The Maastricht Study', Scientific Reports, vol. 7, no. 1, 6610. https://doi.org/10.1038/s41598-017-06978-3

TY - JOUR

T1 - Troponin I and T in relation to cardiac injury detected with electrocardiography in a population-based cohort - The Maastricht Study

AU - Kimenai, Dorien M.

AU - Martens, Remy J. H.

AU - Kooman, Jeroen P.

AU - Stehouwer, Coen D. A.

AU - Tan, Frans E. S.

AU - Schaper, Nicolaas C.

AU - Dagnelie, Pieter C.

AU - Schram, Miranda T.

AU - van der Kallen, Carla J. H.

AU - Sep, Simone J. S.

AU - van Suijlen, Jeroen D. E.

AU - Kroon, Abraham A.

AU - Bekers, Otto

AU - van Dieijen-Visser, Marja P.

AU - Henry, Ronald M. A.

AU - Meex, Steven J. R.

PY - 2017/7/26

Y1 - 2017/7/26

N2 - Interest in high-sensitivity cardiac troponin I(hs-cTnI) and T(hs-cTnT) has expanded from acute cardiac care to cardiovascular disease(CVD) risk stratification. Whether hs-cTnI and hs-cTnT are interchangeable in the ambulant setting is largely unexplored. Cardiac injury is a mechanism that may underlie the associations between troponin levels and mortality in the general population. In the population-based Maastricht Study, we assessed the correlation and concordance between hs-cTnI and hs-cTnT. Multiple regression analyses were conducted to assess the association of hs-cTnI and hs-cTnT with electrocardiographic (ECG) changes indicative of cardiac abnormalities. In 3016 eligible individuals(mean age, 60 +/- 8 years; 50.6%, men) we found a modest correlation between hs-cTnI and hs-cTnT(r = 0.585). After multiple adjustment, the association with ECG changes indicative of cardiac abnormalities was similar for both hs-cTn assays(OR, hs-cTnI: 1.72,95% CI: 1.40-2.10; OR, hs-cTnT: 1.60,95% CI: 1.22-2.11). The concordance of dichotomized hs-cTnI and hs-cTnT was kappa =0.397 (>= sex-specific 75th percentile). Isolated high levels of hs-cTnI were associated with ECG changes indicative of cardiac abnormalities(OR: 1.93,95% CI: 1.01-3.68), whereas isolated high levels of hs-cTnT were not(OR: 1.07,95% CI: 0.49-2.31). In conclusion, there is a moderate correlation and limited concordance between hs-cTnI and hs-cTnT under non-acute conditions. These data suggest that associations of hs-cTnI and hs-cTnT with cardiac injury detected by ECG are driven by different mechanisms. This information may benefit future development of CVD risk stratification algorithms.

AB - Interest in high-sensitivity cardiac troponin I(hs-cTnI) and T(hs-cTnT) has expanded from acute cardiac care to cardiovascular disease(CVD) risk stratification. Whether hs-cTnI and hs-cTnT are interchangeable in the ambulant setting is largely unexplored. Cardiac injury is a mechanism that may underlie the associations between troponin levels and mortality in the general population. In the population-based Maastricht Study, we assessed the correlation and concordance between hs-cTnI and hs-cTnT. Multiple regression analyses were conducted to assess the association of hs-cTnI and hs-cTnT with electrocardiographic (ECG) changes indicative of cardiac abnormalities. In 3016 eligible individuals(mean age, 60 +/- 8 years; 50.6%, men) we found a modest correlation between hs-cTnI and hs-cTnT(r = 0.585). After multiple adjustment, the association with ECG changes indicative of cardiac abnormalities was similar for both hs-cTn assays(OR, hs-cTnI: 1.72,95% CI: 1.40-2.10; OR, hs-cTnT: 1.60,95% CI: 1.22-2.11). The concordance of dichotomized hs-cTnI and hs-cTnT was kappa =0.397 (>= sex-specific 75th percentile). Isolated high levels of hs-cTnI were associated with ECG changes indicative of cardiac abnormalities(OR: 1.93,95% CI: 1.01-3.68), whereas isolated high levels of hs-cTnT were not(OR: 1.07,95% CI: 0.49-2.31). In conclusion, there is a moderate correlation and limited concordance between hs-cTnI and hs-cTnT under non-acute conditions. These data suggest that associations of hs-cTnI and hs-cTnT with cardiac injury detected by ECG are driven by different mechanisms. This information may benefit future development of CVD risk stratification algorithms.

KW - GLOMERULAR-FILTRATION-RATE

KW - HIGHLY SENSITIVE ASSAY

KW - CARDIOVASCULAR RISK

KW - GENERAL-POPULATION

KW - COGNITIVE PERFORMANCE

KW - HEALTHY POPULATION

KW - PROGNOSTIC VALUE

KW - MORTALITY

KW - DISEASE

KW - COMMUNITY

U2 - 10.1038/s41598-017-06978-3

DO - 10.1038/s41598-017-06978-3

M3 - Article

C2 - 28747765

SN - 2045-2322

VL - 7

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 6610

ER -

Troponin I and T in relation to cardiac injury detected with electrocardiography in a population-based cohort - The Maastricht Study

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Keywords

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