Association of Troponin T Detected With a Highly Sensitive Assay and Cardiac Structure and Mortality Risk in the General Population

作者：James A. de Lemos, Mark H. Drazner, Torbjørn Omland, Colby Ayers, Amit Khera, Anand Rohatgi, Ibrahim A. Hashim, Jarett D. Berry, Sandeep R. Das, David A. Morrow, Darren K. McGuire · 发表于：JAMA · 年份：2010 · DOI：10.1001/jama.2010.1768 · 被引用次数：1107 · 研究领域：Acute Myocardial Infarction Research、Cardiomyopathy and Myosin Studies、Cardiac Imaging and Diagnostics

CONTEXT: Detectable levels of cardiac troponin T (cTnT) are strongly associated with structural heart disease and increased risk of death and adverse cardiovascular events; however, cTnT is rarely detectable in the general population using standard assays. OBJECTIVES: To determine the prevalence and determinants of detectable cTnT in the population using a new highly sensitive assay and to assess whether cTnT levels measured with the new assay associate with pathological cardiac phenotypes and subsequent mortality. DESIGN, SETTING, AND PARTICIPANTS: Cardiac troponin T levels were measured using both the standard and the highly sensitive assays in 3546 individuals aged 30 to 65 years enrolled between 2000 and 2002 in the Dallas Heart Study, a multiethnic, population-based cohort study. Mortality follow-up was complete through 2007. Participants were placed into 5 categories based on cTnT levels. MAIN OUTCOME MEASURES: Magnetic resonance imaging measurements of cardiac structure and function and mortality through a median of 6.4 (interquartile range, 6.0-6.8) years of follow-up. RESULTS: In Dallas County, the prevalence of detectable cTnT (≥0.003 ng/mL) was 25.0% (95% confidence interval [CI], 22.7%-27.4%) with the highly sensitive assay vs 0.7% (95% CI, 0.3%-1.1%) with the standard assay. Prevalence was 37.1% (95% CI, 33.3%-41.0%) in men vs 12.9% (95% CI, 10.6%-15.2%) in women and 14.0% (95% CI, 11.2%-16.9%) in participants younger than 40 years vs 57.6% (95% CI, 47.0%-68.2%) ...