title: High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults.
abstract: High-sensitivity cardiac troponin I (hs-cTnI) is a novel biomarker of myocardial injury and ischaemia. Our objective was to ascertain correlates of hs-cTnI and its incremental prognostic utility for incident coronary heart disease (CHD) among older asymptomatic subjects.
  
  
  
  We performed a cohort study among 1135 asymptomatic control participants in the ADVANCE (Atherosclerotic Disease, VAscular FunctioN and GenetiC Epidemiology) study at Kaiser Permanente Northern California and Stanford University, with follow-up through 31 December 2014. Hs-cTnI was measured in stored baseline (2002-2004) serum samples.
  
  
  
  After a median follow-up of 11.3 years, 164 CHD events were documented. The most significant correlates of hs-cTnI were black race, body mass index, hypertension, LDL cholesterol and estimated glomerular filtration rate (eGFR) (R(2)=0.16) After adjustment for race/ethnicity, education level, diabetes status, ATP-III Framingham risk score (FRS), C reactive protein and eGFR, each 1 SD increment of log-transformed Hs-cTnI was associated with 1.11 (95% CI 1.01 to 1.23, p=0.04) increased hazard of CHD. The c-statistic increased to 0.70 from 0.68 (p=0.16) and the category-based net reclassification index was 18% (95% CI 8% to 30%) after adding hs-cTnI to the model containing the ATP-III FRS.
  
  
  
  Hs-cTnI conveys incremental prognostic information for incident CHD among asymptomatic older adults.
authors.affiliation: Kaiser Permanente Northern California Division of Research, Oakland, California, USA San Francisco Departments of Epidemiology, University of California, Biostatistics and Medicine, San Francisco, California, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Iribarren
authors.affiliation: Kaiser Permanente Northern California Division of Research, Oakland, California, USA.
authors.forename: Malini
authors.initials: M
authors.lastname: Chandra
authors.affiliation: Division of Cardiology, Kaiser Permanente Oakland Medical Center, Oakland, California, USA.
authors.forename: Jamal S
authors.initials: JS
authors.lastname: Rana
authors.affiliation: Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hlatky
authors.affiliation: Stanford University School of Medicine, Palo Alto, California, USA Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Fortmann
authors.affiliation: Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Quertermous
authors.affiliation: Kaiser Permanente Northern California Division of Research, Oakland, California, USA San Francisco Departments of Epidemiology, University of California, Biostatistics and Medicine, San Francisco, California, USA Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Go
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D019210:Troponin I / Q000097:blood*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D019210:Troponin I