In patients with stable angina, the association between high-sensitivity cardiac troponin
T (hs-cTnT) and incident acute myocardial infarction (AMI), as well as pathophysiologic
mechanisms accounting for an adverse prognosis, remain to be determined. We explored
the association between hs-cTnT and future AMI among 3,882 patients evaluated for
suspected stable angina pectoris and investigated to which extent hs-cTnT attenuated
the relations between traditional coronary heart disease (CHD) risk factors and AMI.
Associations between increasing hs-cTnT categories (≤3, 4 to 9, 10 to 19, and 20 to
30 ng/L) and risk of AMI were studied by Cox regression. We investigated whether the
associations between traditional CHD risk factors and future AMI were influenced by
adjusting for hs-cTnT. Median age was 62 years. During median (25th to 75th percentile)
8 (6.4 to 8.7) years of follow-up, 460 (11.8%) experienced an AMI. There was a strong
association between hs-cTnT categories and risk of AMI. The relation was somewhat
attenuated, but still present, when adjusting for potential confounders, traditional
CHD risk factors, previous peripheral vascular disease, and percutaneous coronary
intervention or coronary bypass surgery. Moreover, hs-cTnT slightly attenuated the
risk relations between traditional CHD risk factors and incident AMI, but each risk
factor remained significantly associated with AMI. In conclusion, among patients with
suspected stable angina, hs-cTnT was positively related to incident AMI.
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Article info
Publication history
Published online: July 04, 2018
Accepted:
June 26,
2018
Received in revised form:
June 19,
2018
Received:
April 16,
2018
Footnotes
The research is funded by Department of Heart Disease, Haukeland University Hospital. There are no disclosures.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
