title: Prognostic value of cardiac troponin I measured with a highly sensitive assay in patients with stable coronary artery disease.
abstract: OBJECTIVE
  The aims of this study were to assess the prognostic value of cardiac troponin I levels, measured with a new high-sensitivity assay, in low-risk patients with stable coronary artery disease (CAD) and to contrast its determinants and prognostic merit with that of high-sensitivity cardiac troponin T (hs-TnT).
  
  
  BACKGROUND
  New, highly sensitive cardiac troponin assays permit evaluation of the association between troponin levels and outcomes in patients with stable CAD.
  
  
  METHODS
  High-sensitivity cardiac troponin I (hs-TnI) levels at baseline were assessed in 3,623 patients with stable CAD and preserved systolic function enrolled in the PEACE (Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy) trial.
  
  
  RESULTS
  In total, 98.5% of patients had hs-TnI concentrations higher than the detection level (1.2 pg/ml). hs-TnI correlated moderately with hs-TnT (r = 0.44) and N-terminal pro-B-type natriuretic peptide (r = 0.39) but only weakly with age (r = 0.17) and estimated glomerular filtration rate (r = -0.11). During a median follow-up period of 5.2 years, 203 patients died of cardiovascular causes or were hospitalized for heart failure, and 209 patients had nonfatal myocardial infarctions. In analyses adjusting for conventional risk markers, N-terminal pro-B-type natriuretic peptide, and hs-TnT, hs-TnI levels in the fourth compared with the 3 lower quartiles were associated with the incidence of cardiovascular death or heart failure (hazard ratio: 1.84; 95% confidence interval: 1.30 to 2.61; p < 0.001). [corrected]. There was a [corrected] weaker association with nonfatal myocardial infarction (hazard ratio: 1.37; 95% confidence interval: 0.98 to 1.92; p = 0.066). [corrected]. In the same models, hs-TnT concentrations were associated with the incidence of cardiovascular death or heart failure but not of myocardial infarction.
  
  
  CONCLUSIONS
  In patients with stable CAD, hs-TnI concentrations are associated with cardiovascular risk independently of conventional risk markers and hs-TnT. (Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy [PEACE]; NCT00000558).
authors: Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway. torbjorn.omland@medisin.uio.no
authors: Torbjørn
authors: T
authors: Omland
authors: Marc A
authors: MA
authors: Pfeffer
authors: Scott D
authors: SD
authors: Solomon
authors: James A
authors: JA
authors: de Lemos
authors: Helge
authors: H
authors: Røsjø
authors: Jūratė
authors: J
authors: Šaltytė Benth
authors: Aldo
authors: A
authors: Maggioni
authors: Michael J
authors: MJ
authors: Domanski
authors: Jean L
authors: JL
authors: Rouleau
authors: Marc S
authors: MS
authors: Sabatine
authors: Eugene
authors: E
authors: Braunwald
mesh_terms: D000367:Age Factors; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012307:Risk Factors; D013223:Statistics as Topic; D015996:Survival Rate; D019210:Troponin I / Q000097:blood*; D014481:United States
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D007211:Indoles; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; C052035:trandolapril