title: High-sensitivity cardiac troponin T in patients with intermittent claudication and its relation with cardiovascular events and all-cause mortality--the CAVASIC Study.
abstract: BACKGROUND
  Serum concentrations of high-sensitivity cardiac troponin T (hs-cTnT) are elevated in various diseases. The role of this marker in peripheral arterial disease (PAD) has not been fully investigated.
  
  
  METHODS
  Hs-cTnT was measured in the CAVASIC Study, a male cohort of 235 patients diagnosed with intermittent claudication and 249 age- and diabetes-matched controls. Patients with symptomatic PAD were prospectively followed for a median time of 7 years. The association of hs-cTnT with PAD, cardiovascular disease (CVD) at baseline as well as incident CVD and all-cause mortality during follow-up was analyzed.
  
  
  RESULTS
  Detectable hs-cTnT was associated with an 84% higher probability for symptomatic PAD at baseline: OR = 1.84, 95%CI 1.05-3.21, p = 0.03. Inclusion of ln-NT-proBNP or prevalent CVD abolished this association (both OR = 1.22, p = 0.52). However, detectable hs-cTnT was associated with prevalent CVD (n = 69) in PAD patients independent from ln-NT-proBNP: OR = 3.42, p = 0.001. In the adjusted Cox regression analysis detectable (HR = 2.15, p = 0.05) and especially hs-cTnT ≥ 14 ng/L (HR = 5.06, p < 0.001) were predictive for all-cause mortality (n = 39) independent from ln-NT-proBNP. Furthermore, hs-cTnT ≥ 14 ng/L was significantly associated with incident CVD (n = 66): HR = 3.15, 95%CI 1.26-7.89, p = 0.01.
  
  
  CONCLUSIONS
  This study in male patients with intermittent claudication and age- and diabetes-matched controls revealed hs-cTnT to be associated with PAD and prevalent CVD. The latter association was even significant after considering NT-proBNP. Prospectively, in PAD patients hs-cTnT was predictive for incident cardiovascular diseases and all-cause mortality. Thus, hs-cTnT could be a surrogate marker for cardiomyocyte damage also in symptomatic PAD patients.
authors.affiliation: Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Pohlhammer
authors.affiliation: Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Kronenberg
authors.affiliation: Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria; Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Rantner
authors.affiliation: 3rd Medical Department of Metabolic Diseases and Nephrology, Hietzing Hospital, Vienna, Austria; King's College London, Diabetes Research Group, London, United Kingdom.
authors.forename: Marietta
authors.initials: M
authors.lastname: Stadler
authors.affiliation: 3rd Medical Department of Metabolic Diseases and Nephrology, Hietzing Hospital, Vienna, Austria.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Peric
authors.affiliation: Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Angelika
authors.initials: A
authors.lastname: Hammerer-Lercher
authors.affiliation: Clinic for Angiology, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Klein-Weigel
authors.affiliation: Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Gustav
authors.initials: G
authors.lastname: Fraedrich
authors.affiliation: Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria. Electronic address: Barbara.Kollerits@i-med.ac.at.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kollerits
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D016017:Odds Ratio; D010446:Peptide Fragments / Q000378:metabolism; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000401:mortality; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
chemical_list: D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Cardiovascular disease; High-sensitivity cardiac troponin T; Mortality; NT-proBNP; Peripheral arterial disease