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    High-sensitivity cardiac troponin T and the risk of incident atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study

    Access Status
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    Authors
    Filion, K.
    Agarwal, S.
    Ballantyne, C.
    Eberg, M.
    Hoogeveen, R.
    Huxley, Rachel
    Loehr, L.
    Nambi, V.
    Soliman, E.
    Alonso, A.
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Filion, K. and Agarwal, S. and Ballantyne, C. and Eberg, M. and Hoogeveen, R. and Huxley, R. and Loehr, L. et al. 2015. High-sensitivity cardiac troponin T and the risk of incident atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. American Heart Journal. 169 (1): pp. 31-38.e3.
    Source Title
    Am Heart J
    DOI
    10.1016/j.ahj.2014.10.005
    ISSN
    0002-8703
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/25447
    Collection
    • Curtin Research Publications
    Abstract

    INTRODUCTION: Structural changes in the heart are known risk factors for atrial fibrillation (AF). An association between high-sensitivity cardiac troponin T (hs-cTnT), a marker of myocardial cell damage measured with a high-sensitivity assay, and the risk of AF could have implications for AF risk stratification. OBJECTIVE: To estimate the association between hs-cTnT and the risk of incident AF in the ARIC study, a prospective cohort of middle-aged adults from 4 US communities. METHODS: Study included 10,584 participants (mean age 62.7 years) free of AF in 1996 to 1998 and followed through 2008. Atrial fibrillation was defined using International Classification of Diseases codes from hospitalizations and death certificates. Participants with undetectable hs-cTnT levels (58%) were assigned the lower limit of measurement (5 ng/L). Net reclassification improvement was used to examine the discriminative ability of hs-cTnT for 10-year AF risk prediction (categories: <5%, 5%-15%, and >15%). RESULTS: A total of 920 incident AF cases were observed for 109,227 person-years. After adjustment, a 1-SD difference in ln(hs-cTnT) was associated with a hazard ratio of 1.16 (95% CI 1.10-1.23). Compared with those with undetectable levels, participants with hs-cTnT =14 ng/L had a hazard ratio of 1.78 (95% CI 1.43-2.24). Addition of hs-cTnT to known AF predictors did not increase the c statistic appreciably (0.756 vs 0.758) or improve risk stratification (net reclassification improvement 0.4%, 95% CI -1.4% to 2.3%). CONCLUSIONS: High-sensitivity cTnT level is associated with an increased incidence rate of AF but did not improve risk stratification.

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