title: Association between high-sensitivity troponin T and cardiovascular risk in individuals with and without metabolic syndrome: The ARIC study.
abstract: Background Metabolic syndrome (MetS) is associated with increased risk for cardiovascular disease, but there is heterogeneity in this risk. We evaluated whether high-sensitivity troponin T (hs-cTnT), a marker associated with cardiovascular disease, can stratify risk in MetS. Methods We evaluated associations between MetS (and groups with similar number of MetS components) and incident heart failure hospitalization, coronary heart disease, stroke and death using hs-cTnT categories after adjusting for risk factors/markers between 1996 and 2011 in 8204 individuals in the Atherosclerosis Risk In Communities study. Results The mean age of the population was 63 years (56% women, 19% Blacks). hs-cTnT levels were higher with MetS and with increasing MetS components. In individuals with MetS, higher hs-cTnT levels were associated with increased hazard ratios for heart failure, coronary heart disease and death. Within each number of MetS components, higher hs-cTnT was associated with progressively higher heart failure, coronary heart disease and death hazards. The association was particularly strong for heart failure. With increasing hs-cTnT categories, the hazard ratios (95% confidence interval) for heart failure in individuals with MetS increased gradually from 1.68 (1.31-2.16) to 3.76 (2.69-5.26) ( p-trend < 0.001) compared with those with MetS and hs-cTnT < 5 ng/l; and respective hazard ratios with increasing hs-cTnT categories in those with all five MetS components ranged from 2.22 (1.17-4.21) to 4.23 (1.89-9.50) ( p-trend 0.004) compared with those with all five MetS components and hs-cTnT < 5 ng/l. However, mostly there were no significant interactions of hs-cTnT with MetS or its components. Conclusion hs-cTnT is useful for identifying MetS patients with increased hazards for coronary heart disease, death and particularly heart failure.
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.|2 Methodist DeBakey Heart Center, Houston, USA.|3 Mid America Heart Institute, Kansas City, USA.
authors.forename: Yashashwi
authors.initials: Y
authors.lastname: Pokharel
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.
authors.forename: Wensheng
authors.initials: W
authors.lastname: Sun
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.|4 Michael E DeBakey Veterans Affairs Hospital, Houston, USA.
authors.forename: Dennis T
authors.initials: DT
authors.lastname: Villareal
authors.affiliation: 5 Johns Hopkins University, Baltimore, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.|2 Methodist DeBakey Heart Center, Houston, USA.|4 Michael E DeBakey Veterans Affairs Hospital, Houston, USA.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
authors.affiliation: 5 Johns Hopkins University, Baltimore, USA.
authors.forename: Chiadi E
authors.initials: CE
authors.lastname: Ndumele
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.|2 Methodist DeBakey Heart Center, Houston, USA.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.affiliation: 5 Johns Hopkins University, Baltimore, USA.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: 6 University of Texas Health Science Center, Houston, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Boerwinkle
authors.affiliation: 7 University of Mississippi Medical Center, Jackson, USA.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Butler
authors.affiliation: 8 Harvard Medical School, Brigham and Women's Hospital, Boston, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Solomon
authors.affiliation: 9 University of Minnesota, Minneapolis, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.|4 Michael E DeBakey Veterans Affairs Hospital, Houston, USA.
authors.forename: Biykem
authors.initials: B
authors.lastname: Bozkurt
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.|2 Methodist DeBakey Heart Center, Houston, USA.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: 1 Baylor College of Medicine, Houston, USA.|2 Methodist DeBakey Heart Center, Houston, USA.|4 Michael E DeBakey Veterans Affairs Hospital, Houston, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
mesh_terms: D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D020107:Troponin T / Q000097:blood*; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: Metabolic syndrome; coronary heart disease; heart failure; high-sensitive troponin T; risk stratification