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Heart Rhythm. 2015 May;12(5):879-85. doi: 10.1016/j.hrthm.2015.01.020. Epub 2015 Jan 17.

Serial measures of cardiac troponin T levels by a highly sensitive assay and incident atrial fibrillation in a prospective cohort of ambulatory older adults.

Author information

1
Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address: husseia@ccf.org.
2
University of Washington, Seattle, Washington.
3
University of Maryland, Baltimore, Maryland.
4
Northwestern University, Evanston, Illinois.
5
Albert Einstein College of Medicine, Bronx, New York.
6
Cleveland Clinic Foundation, Cleveland, Ohio.

Abstract

BACKGROUND:

Various mechanisms in cardiac remodeling related to atrial fibrillation (AF) lead to elevated circulating cardiac troponin levels, but little is known about such elevations upstream to AF onset.

OBJECTIVE:

The purpose of this study was to study the association between circulating troponin levels as assessed by a highly sensitive cardiac troponin T (hs-cTnT) assay and incident atrial fibrillation (AF).

METHODS:

In a large prospective cohort of ambulatory older adults [the Cardiovascular Health Study (CHS)], hs-cTnT levels were measured in sera that were collected at enrollment from 4262 participants without AF (2871 with follow-up measurements). Incident AF was identified by electrocardiograms during CHS visits, hospital discharge diagnoses, and Medicare files, including outpatient and physician claims diagnoses.

RESULTS:

Over median follow-up of 11.2 years (interquartile range 6.1-16.5), 1363 participants (32.0%) developed AF. Higher baseline levels of hs-cTnT were associated with incident AF in covariate-adjusted analyses accounting for demographics, traditional risk factors, and incident heart failure in time-dependent analyzes (hazard ratio for 3rd tertile vs undetectable 1.75, 95% confidence interval 1.48-2.08). This association was statistically significant in analyses that additionally adjusted for biomarkers of inflammation and hemodynamic strain (hazard ratio for 3rd tertile vs undetectable 1.38, 95% confidence interval 1.16-1.65). Significant associations were also found when hs-cTnT levels were treated as a continuous variable and when examining change from baseline of hs-cTnT levels and incident AF.

CONCLUSION:

The findings show a significant association of circulating troponin levels in ambulatory older adults with incident AF beyond that of traditional risk factors, incident heart failure, and biomarkers of inflammation and hemodynamic strain.

KEYWORDS:

Atrial fibrillation; Biomarker; Cardiac remodeling Aging

PMID:
25602173
PMCID:
PMC4546831
DOI:
10.1016/j.hrthm.2015.01.020
[Indexed for MEDLINE]
Free PMC Article

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