医学
肌钙蛋白
危险系数
内科学
置信区间
肌钙蛋白T
人口
肌钙蛋白I
全国健康与营养检查调查
罗氏诊断公司
心脏病学
心肌梗塞
环境卫生
作者
John W. McEvoy,Natalie Daya,Olive Tang,Michael Fang,Chiadi E Ndumele,Josef Coresh,Robert H. Christenson,Elizabeth Selvin
标识
DOI:10.1093/eurheartj/ehad328
摘要
Abstract Aims Cardiac troponin T and I can be measured using a number of high-sensitivity (hs) assays. This study aimed to characterize correlations between four such assays and test their comparative associations with mortality. Methods and results Among adults without cardiovascular disease in the 1999–2004 National Health and Nutrition Examination Survey, hs-troponin T was measured using one assay (Roche) and hs-troponin I using three assays (Abbott, Siemens, and Ortho). Cox regression was used to estimate associations with all-cause and cardiovascular mortality. Pearson’s correlation coefficients comparing concentrations from each assay ranged from 0.53 to 0.77. There were 2188 deaths (488 cardiovascular) among 9810 participants. Each hs-troponin assay [log-transformed, per 1 standard deviation (SD)] was independently associated with all-cause mortality: hazard ratio (HR) 1.20 [95% confidence interval (CI) 1.13–1.28] for Abbott hs-troponin I; HR 1.10 (95% CI 1.02–1.18) for Siemens hs-troponin I; HR 1.23 (95% CI 1.14–1.33) for Ortho hs-troponin I; and HR 1.31 (95% CI 1.21–1.42) for Roche hs-troponin T. Each hs-troponin assay was also independently associated with cardiovascular mortality (HR 1.44 to 1.65 per 1 SD). Associations of hs-troponin T and all-cause and cardiovascular mortality remained significant after adjusting for hs-troponin I. Furthermore, associations of hs-troponin I remained significant after mutually adjusting for hs-troponin I from the other individual assays: e.g. cardiovascular mortality HR 1.46 (95% CI 1.19–1.79) for Abbott after adjustment for the Siemens assay and HR 1.29 (95% CI 1.09–1.53) for Abbott after adjustment for the Ortho assay. Conclusion This study demonstrates only modest correlations between hs-troponin T and three hs-troponin I assays and that hs-troponin I assays can provide distinct risk information for mortality in the general population.
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