Highly sensitive cardiac troponin T and long-term mortality in a population of community-derived perimenopausal women

Nested case-control study

G.E. Cramer, M.A.R. Brouwer, H.L. Vader, M.J. de Boer, G.A.M. Pop, V.J.M. Pop, F.W. Verheugt

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
To assess the association between baseline levels of highly sensitive cardiac troponin T (hs-cTnT) and long-term mortality in perimenopausal women of the general community using a gender specific 99th percentile reference limit.
Design
Nested case control.
Setting
The present study was conducted within the Eindhoven Perimenopausal Osteoporosis Study which is a large prospective cohort of 8503 community-derived women of the city of Eindhoven, The Netherlands.
Participants
Cases were defined as Eindhoven Perimenopausal Osteoporosis Study participants who provided an adequate baseline blood sample and subsequently experienced death during follow-up between 1994 and 2003. In total, 123 cases were identified. For each case two matched controls were selected using age, body mass index and hypertension as matching factors. The gender specific 99th percentile reference limit determined in the 246 controls was 8.0 ng/l.
Main outcome measure
All cause mortality.
Results
Hs-cTnT was significantly higher in the cases: 3.0 ng/l versus 2.3 ng/l (p=0.04). After adjustment for matching and clinical risk factors, each 1 SD increase of the level of hs-cTnT was significantly associated with mortality (OR 1.3, 95% CI 1.1 to 1.7, p=0.018). With amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in the multivariable model as a continuous variable the association of hs-cTnT with mortality was lost. With both hs-cTnT and NT-proBNP as dichotomous variables, the gender specific 99th percentile reference limit (8.0 ng/l) was associated with mortality, independent of NT-proBNP (OR 3.7, 95% CI 1.0 to 13.2, p=0.048).
Conclusions
In this study of community-derived perimenopausal women, hs-cTnT was associated with long-term mortality, independent of clinical risk factors. With the use of easily applicable cut-off levels, the gender specific reference limit of hs-cTnT had a prognostic impact that was independent of NT-proBNP.
Original languageEnglish
Pages (from-to)528-533
JournalHeart
Volume99
Issue number8
DOIs
Publication statusPublished - 2013

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Troponin T
Brain Natriuretic Peptide
Netherlands
Body Mass Index

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Cramer, G.E. ; Brouwer, M.A.R. ; Vader, H.L. ; de Boer, M.J. ; Pop, G.A.M. ; Pop, V.J.M. ; Verheugt, F.W. / Highly sensitive cardiac troponin T and long-term mortality in a population of community-derived perimenopausal women : Nested case-control study. In: Heart. 2013 ; Vol. 99, No. 8. pp. 528-533.
@article{c3eacd44ba224f64897f58d7d73f5c84,
title = "Highly sensitive cardiac troponin T and long-term mortality in a population of community-derived perimenopausal women: Nested case-control study",
abstract = "Objective To assess the association between baseline levels of highly sensitive cardiac troponin T (hs-cTnT) and long-term mortality in perimenopausal women of the general community using a gender specific 99th percentile reference limit.Design Nested case control.Setting The present study was conducted within the Eindhoven Perimenopausal Osteoporosis Study which is a large prospective cohort of 8503 community-derived women of the city of Eindhoven, The Netherlands.Participants Cases were defined as Eindhoven Perimenopausal Osteoporosis Study participants who provided an adequate baseline blood sample and subsequently experienced death during follow-up between 1994 and 2003. In total, 123 cases were identified. For each case two matched controls were selected using age, body mass index and hypertension as matching factors. The gender specific 99th percentile reference limit determined in the 246 controls was 8.0 ng/l.Main outcome measure All cause mortality.Results Hs-cTnT was significantly higher in the cases: 3.0 ng/l versus 2.3 ng/l (p=0.04). After adjustment for matching and clinical risk factors, each 1 SD increase of the level of hs-cTnT was significantly associated with mortality (OR 1.3, 95{\%} CI 1.1 to 1.7, p=0.018). With amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in the multivariable model as a continuous variable the association of hs-cTnT with mortality was lost. With both hs-cTnT and NT-proBNP as dichotomous variables, the gender specific 99th percentile reference limit (8.0 ng/l) was associated with mortality, independent of NT-proBNP (OR 3.7, 95{\%} CI 1.0 to 13.2, p=0.048).Conclusions In this study of community-derived perimenopausal women, hs-cTnT was associated with long-term mortality, independent of clinical risk factors. With the use of easily applicable cut-off levels, the gender specific reference limit of hs-cTnT had a prognostic impact that was independent of NT-proBNP.",
author = "G.E. Cramer and M.A.R. Brouwer and H.L. Vader and {de Boer}, M.J. and G.A.M. Pop and V.J.M. Pop and F.W. Verheugt",
year = "2013",
doi = "10.1136/heartjnl-2012-302829",
language = "English",
volume = "99",
pages = "528--533",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",
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Highly sensitive cardiac troponin T and long-term mortality in a population of community-derived perimenopausal women : Nested case-control study. / Cramer, G.E.; Brouwer, M.A.R.; Vader, H.L.; de Boer, M.J.; Pop, G.A.M.; Pop, V.J.M.; Verheugt, F.W.

In: Heart, Vol. 99, No. 8, 2013, p. 528-533.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Highly sensitive cardiac troponin T and long-term mortality in a population of community-derived perimenopausal women

T2 - Nested case-control study

AU - Cramer, G.E.

AU - Brouwer, M.A.R.

AU - Vader, H.L.

AU - de Boer, M.J.

AU - Pop, G.A.M.

AU - Pop, V.J.M.

AU - Verheugt, F.W.

PY - 2013

Y1 - 2013

N2 - Objective To assess the association between baseline levels of highly sensitive cardiac troponin T (hs-cTnT) and long-term mortality in perimenopausal women of the general community using a gender specific 99th percentile reference limit.Design Nested case control.Setting The present study was conducted within the Eindhoven Perimenopausal Osteoporosis Study which is a large prospective cohort of 8503 community-derived women of the city of Eindhoven, The Netherlands.Participants Cases were defined as Eindhoven Perimenopausal Osteoporosis Study participants who provided an adequate baseline blood sample and subsequently experienced death during follow-up between 1994 and 2003. In total, 123 cases were identified. For each case two matched controls were selected using age, body mass index and hypertension as matching factors. The gender specific 99th percentile reference limit determined in the 246 controls was 8.0 ng/l.Main outcome measure All cause mortality.Results Hs-cTnT was significantly higher in the cases: 3.0 ng/l versus 2.3 ng/l (p=0.04). After adjustment for matching and clinical risk factors, each 1 SD increase of the level of hs-cTnT was significantly associated with mortality (OR 1.3, 95% CI 1.1 to 1.7, p=0.018). With amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in the multivariable model as a continuous variable the association of hs-cTnT with mortality was lost. With both hs-cTnT and NT-proBNP as dichotomous variables, the gender specific 99th percentile reference limit (8.0 ng/l) was associated with mortality, independent of NT-proBNP (OR 3.7, 95% CI 1.0 to 13.2, p=0.048).Conclusions In this study of community-derived perimenopausal women, hs-cTnT was associated with long-term mortality, independent of clinical risk factors. With the use of easily applicable cut-off levels, the gender specific reference limit of hs-cTnT had a prognostic impact that was independent of NT-proBNP.

AB - Objective To assess the association between baseline levels of highly sensitive cardiac troponin T (hs-cTnT) and long-term mortality in perimenopausal women of the general community using a gender specific 99th percentile reference limit.Design Nested case control.Setting The present study was conducted within the Eindhoven Perimenopausal Osteoporosis Study which is a large prospective cohort of 8503 community-derived women of the city of Eindhoven, The Netherlands.Participants Cases were defined as Eindhoven Perimenopausal Osteoporosis Study participants who provided an adequate baseline blood sample and subsequently experienced death during follow-up between 1994 and 2003. In total, 123 cases were identified. For each case two matched controls were selected using age, body mass index and hypertension as matching factors. The gender specific 99th percentile reference limit determined in the 246 controls was 8.0 ng/l.Main outcome measure All cause mortality.Results Hs-cTnT was significantly higher in the cases: 3.0 ng/l versus 2.3 ng/l (p=0.04). After adjustment for matching and clinical risk factors, each 1 SD increase of the level of hs-cTnT was significantly associated with mortality (OR 1.3, 95% CI 1.1 to 1.7, p=0.018). With amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in the multivariable model as a continuous variable the association of hs-cTnT with mortality was lost. With both hs-cTnT and NT-proBNP as dichotomous variables, the gender specific 99th percentile reference limit (8.0 ng/l) was associated with mortality, independent of NT-proBNP (OR 3.7, 95% CI 1.0 to 13.2, p=0.048).Conclusions In this study of community-derived perimenopausal women, hs-cTnT was associated with long-term mortality, independent of clinical risk factors. With the use of easily applicable cut-off levels, the gender specific reference limit of hs-cTnT had a prognostic impact that was independent of NT-proBNP.

U2 - 10.1136/heartjnl-2012-302829

DO - 10.1136/heartjnl-2012-302829

M3 - Article

VL - 99

SP - 528

EP - 533

JO - Heart

JF - Heart

SN - 1355-6037

IS - 8

ER -