High-Sensitivity Cardiac Troponin and New-Onset Heart Failure A Systematic Review and Meta-Analysis of 67,063 Patients With 4,165 Incident Heart Failure Events

被引:66
作者
Evans, Jonathan D. W. [1 ,2 ]
Dobbin, Stephen J. H. [3 ]
Pettit, Stephen J. [2 ]
Di Angelantonio, Emanuele [1 ,4 ,5 ]
Willeit, Peter [1 ,6 ]
机构
[1] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England
[2] Papworth Hosp NHS Fdn Trust, Transplant Unit, Cambridge, England
[3] Golden Jubilee Natl Hosp, Dept Cardiol, Glasgow, Lanark, Scotland
[4] Univ Cambridge, NIHR Blood & Transplant Res Unit Donor Hlth & Gen, Cambridge, England
[5] NHS Blood & Transplant, Cambridge, England
[6] Med Univ Innsbruck, Dept Neurol, Anichstr 35, A-6020 Innsbruck, Austria
关键词
biomarkers; heart failure; meta-analysis; risk prediction; CARDIOVASCULAR RISK; STATIN THERAPY; DISEASE; MORTALITY; POPULATION; PREDICTION; ASSAY; ASSOCIATION; BIOMARKERS; OUTCOMES;
D O I
10.1016/j.jchf.2017.11.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES The aim of this study was to systematically collate and appraise the available evidence regarding the association between high-sensitivity cardiac troponin (hs-cTn) and incident heart failure (HF) and the added value of hs-cTn in HF prediction. BACKGROUND Identification of subjects at high risk for HF and early risk factor modification with medications such as angiotensin-converting enzyme inhibitors may delay the onset of HF. Hs-cTn has been suggested as a prognostic marker for the incidence of first-ever HF in asymptomatic subjects. METHODS PubMed, Embase, and Web of Science were systematically searched for prospective cohort studies published before January 2017 that reported associations between hs-cTn and incident HF in subjects without baseline HF. Study-specific multivariate-adjusted hazard ratios (HRs) were pooled using random-effects meta-analysis. RESULTS Data were collated from 16 studies with a total of 67,063 subjects and 4,165 incident HF events. The average age was 57 years, and 47% were women. Study quality was high (Newcastle-Ottawa score 8.2 of 9). In a comparison of participants in the top third with those in the bottom third of baseline values of hs-cTn, the pooled multivariate-adjusted HR for incident HF was 2.09 (95% confidence interval [CI]: 1.76 to 2.48; p < 0.001). Between-study heterogeneity was high, with an I-2 value of 80%. HRs were similar in men and women (2.29 [95% CI: 1.64 to 3.21] vs. 2.18 [95% CI: 1.68 to 2.81]) and for hs-cTnI and hs-cTnT (2.09 [95% CI: 1.53 to 2.85] vs. 2.11 [95% CI: 1.69 to 2.63]) and across other study-level characteristics. Further adjustment for B-type natriuretic peptide yielded a similar HR of 2.08 (95% CI: 1.64 to 2.65). Assay of hs-cTn in addition to conventional risk factors provided improvements in the C index of 1% to 3%. CONCLUSIONS Available prospective studies indicate a strong association of hs-cTn with the risk of first-ever HF and significant improvements in HF prediction. (c) 2018 by the American College of Cardiology Foundation.
引用
收藏
页码:187 / 197
页数:11
相关论文
共 44 条
[1]   Analytical Characteristics of High-Sensitivity Cardiac Troponin Assays [J].
Apple, Fred S. ;
Collinson, Paul O. .
CLINICAL CHEMISTRY, 2012, 58 (01) :54-61
[2]   High-Sensitivity Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) and Risk of Incident Heart Failure in Patients with CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study [J].
Bansal, Nisha ;
Anderson, Amanda Hyre ;
Yang, Wei ;
Christenson, Robert H. ;
deFilippi, Christopher R. ;
Deo, Rajat ;
Dries, Daniel L. ;
Go, Alan S. ;
He, Jiang ;
Kusek, John W. ;
Lash, James P. ;
Raj, Dominic ;
Rosas, Sylvia ;
Wolf, Myles ;
Zhang, Xiaoming ;
Shlipak, Michael G. ;
Feldman, Harold I. .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2015, 26 (04) :946-956
[3]   Clinical Risk Stratification Optimizes Value of Biomarkers to Predict New-Onset Heart Failure in a Community-Based Cohort [J].
Brouwers, Frank P. ;
van Gilst, Wiek H. ;
Damman, Kevin ;
van den Berg, Maarten P. ;
Gansevoort, Ron T. ;
Bakker, Stephan J. L. ;
Hillege, Hans L. ;
van Veldhuisen, Dirk J. ;
van der Harst, Pim ;
de Boer, Rudolf A. .
CIRCULATION-HEART FAILURE, 2014, 7 (05) :723-U73
[4]  
Chene G, 1996, AM J EPIDEMIOL, V144, P610
[5]   Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease - Meta-analyses of prospective studies [J].
Danesh, J ;
Collins, R ;
Appleby, P ;
Peto, R .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (18) :1477-1482
[6]   Association of Serial Measures of Cardiac Troponin T Using a Sensitive Assay With Incident Heart Failure and Cardiovascular Mortality in Older Adults [J].
deFilippi, Christopher R. ;
de Lemos, James A. ;
Christenson, Robert H. ;
Gottdiener, John S. ;
Kop, Willem J. ;
Zhan, Min ;
Seliger, Stephen L. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2010, 304 (22) :2494-2502
[7]   METAANALYSIS IN CLINICAL-TRIALS [J].
DERSIMONIAN, R ;
LAIRD, N .
CONTROLLED CLINICAL TRIALS, 1986, 7 (03) :177-188
[8]   Population Risk Prediction Models for Incident Heart Failure A Systematic Review [J].
Echouffo-Tcheugui, Justin B. ;
Greene, Stephen J. ;
Papadimitriou, Lampros ;
Zannad, Faiez ;
Yancy, Clyde W. ;
Gheorghiade, Mihai ;
Butler, Javed .
CIRCULATION-HEART FAILURE, 2015, 8 (03) :438-447
[9]   Bias in meta-analysis detected by a simple, graphical test [J].
Egger, M ;
Smith, GD ;
Schneider, M ;
Minder, C .
BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7109) :629-634
[10]   Evaluation of Temporal Changes in Cardiovascular Biomarker Concentrations Improves Risk Prediction in an Elderly Population from the Community [J].
Eggers, Kai M. ;
Kempf, Tibor ;
Larsson, Anders ;
Lindahl, Bertil ;
Venge, Per ;
Wallentin, Lars ;
Wollert, Kai C. ;
Lind, Lars .
CLINICAL CHEMISTRY, 2016, 62 (03) :485-493