TY - JOUR
T1 - Risk prediction of atrial fibrillation and its complications in the community using hs troponin I
AU - Börschel, Christin S.
AU - Geelhoed, Bastiaan
AU - Niiranen, Teemu
AU - Camen, Stephan
AU - Donati, Maria Benedetta
AU - Havulinna, Aki S.
AU - Gianfagna, Francesco
AU - Palosaari, Tarja
AU - Jousilahti, Pekka
AU - Kontto, Jukka
AU - Vartiainen, Erkki
AU - Ojeda, Francisco M.
AU - den Ruijter, Hester M.
AU - Costanzo, Simona
AU - de Gaetano, Giovanni
AU - Di Castelnuovo, Augusto
AU - Linneberg, Allan
AU - Vishram-Nielsen, Julie K.
AU - Løchen, Maja Lisa
AU - Koenig, Wolfgang
AU - Jørgensen, Torben
AU - Kuulasmaa, Kari
AU - Blankenberg, Stefan
AU - Iacoviello, Licia
AU - Zeller, Tanja
AU - Söderberg, Stefan
AU - Salomaa, Veikko
AU - Schnabel, Renate B.
N1 - Publisher Copyright:
© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.
PY - 2023/5
Y1 - 2023/5
N2 - Aims: Atrial fibrillation (AF) is becoming increasingly common. Traditional cardiovascular risk factors (CVRF) do not explain all AF cases. Blood-based biomarkers reflecting cardiac injury such as high-sensitivity troponin I (hsTnI) may help close this gap. Methods: We investigated the predictive ability of hsTnI for incident AF in 45,298 participants (median age 51.4 years, 45.0% men) across European community cohorts in comparison to CVRF and established biomarkers (C-reactive protein, N-terminal pro B-type natriuretic peptide). Results: During a median follow-up of 7.7 years, 1734 (3.8%) participants developed AF. Those in the highest hsTnI quarter (≥4.2 ng/L) had a 3.91-fold (95% confidence interval (CI) 3.30, 4.63; p <.01) risk for developing AF compared to the lowest quarter (<1.4 ng/L). In multivariable-adjusted Cox proportional hazards models a statistically significant association was seen between hsTnI and AF (hazard ratio (HR) per 1 standard deviation (SD) increase in log10(hsTnI) 1.08; 95% CI 1.01, 1.16; p =.03). Inclusion of hsTnI did improve model discrimination (C-index CVRF 0.811 vs. C-index CVRF and hsTnI 0.813; p <.01). Higher hsTnI concentrations were associated with heart failure (HR per SD 1.37; 95% CI 1.12, 1.68; p <.01) and overall mortality (HR per SD 1.24; 95% CI 1.09, 1.41; p <.01). Conclusion: hsTnI as a biomarker of myocardial injury does not improve prediction of AF incidence beyond classical CVRF and NT-proBNP. However, it is associated with the AF-related disease heart failure and mortality likely reflecting underlying subclinical cardiovascular impairment.
AB - Aims: Atrial fibrillation (AF) is becoming increasingly common. Traditional cardiovascular risk factors (CVRF) do not explain all AF cases. Blood-based biomarkers reflecting cardiac injury such as high-sensitivity troponin I (hsTnI) may help close this gap. Methods: We investigated the predictive ability of hsTnI for incident AF in 45,298 participants (median age 51.4 years, 45.0% men) across European community cohorts in comparison to CVRF and established biomarkers (C-reactive protein, N-terminal pro B-type natriuretic peptide). Results: During a median follow-up of 7.7 years, 1734 (3.8%) participants developed AF. Those in the highest hsTnI quarter (≥4.2 ng/L) had a 3.91-fold (95% confidence interval (CI) 3.30, 4.63; p <.01) risk for developing AF compared to the lowest quarter (<1.4 ng/L). In multivariable-adjusted Cox proportional hazards models a statistically significant association was seen between hsTnI and AF (hazard ratio (HR) per 1 standard deviation (SD) increase in log10(hsTnI) 1.08; 95% CI 1.01, 1.16; p =.03). Inclusion of hsTnI did improve model discrimination (C-index CVRF 0.811 vs. C-index CVRF and hsTnI 0.813; p <.01). Higher hsTnI concentrations were associated with heart failure (HR per SD 1.37; 95% CI 1.12, 1.68; p <.01) and overall mortality (HR per SD 1.24; 95% CI 1.09, 1.41; p <.01). Conclusion: hsTnI as a biomarker of myocardial injury does not improve prediction of AF incidence beyond classical CVRF and NT-proBNP. However, it is associated with the AF-related disease heart failure and mortality likely reflecting underlying subclinical cardiovascular impairment.
KW - atrial fibrillation
KW - biomarkers
KW - epidemiology
KW - high-sensitivity troponin I
KW - N-terminal pro B-type natriuretic peptide
UR - https://www.scopus.com/pages/publications/85146341064
U2 - 10.1111/eci.13950
DO - 10.1111/eci.13950
M3 - Article
C2 - 36602448
AN - SCOPUS:85146341064
SN - 0014-2972
VL - 53
JO - European Journal of Clinical Investigation
JF - European Journal of Clinical Investigation
IS - 5
M1 - e13950
ER -