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Cardiac troponin is...
Cardiac troponin is associated with cardiac outcomes in men and women with atrial fibrillation, insights from the ARISTOTLE trial
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- Rosjo, H. (author)
- Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden.;Akershus Univ Hosp, Div Res & Innovat, Sykehusveien 25, N-1478 Lorenskog, Norway.;Univ Oslo, Inst Clin Med, Oslo, Norway.;Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.
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- Hijazi, Ziad (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Omland, T. (author)
- Univ Oslo, Inst Clin Med, Oslo, Norway.;Akershus Univ Hosp, Dept Cardiol, Div Med, Lorenskog, Norway.
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- Westerbergh, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Lyngbakken, M. N. (author)
- Univ Oslo, Inst Clin Med, Oslo, Norway.;Akershus Univ Hosp, Dept Cardiol, Div Med, Lorenskog, Norway.
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- Alexander, J. H. (author)
- Duke Hlth, Duke Clin Res Inst, Durham, NC USA.
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- Gersh, B. J. (author)
- Mayo Clin, Coll Med, Rochester, MN USA.
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- Granger, C. B. (author)
- Duke Hlth, Duke Clin Res Inst, Durham, NC USA.
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- Hylek, E. M. (author)
- Boston Univ, Med Ctr, Boston, MA USA.
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- Lopes, R. D. (author)
- Duke Hlth, Duke Clin Res Inst, Durham, NC USA.
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi,Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.;Uppsala Univ, Clin Chem, Dept Med Sci, Uppsala, Sweden.
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper,Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden.;Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.
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Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden;Akershus Univ Hosp, Div Res & Innovat, Sykehusveien 25, N-1478 Lorenskog, Norway.;Univ Oslo, Inst Clin Med, Oslo, Norway.;Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden. Uppsala kliniska forskningscentrum (UCR) (creator_code:org_t)
- 2020-05-18
- 2020
- English.
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In: Journal of Internal Medicine. - : WILEY. - 0954-6820 .- 1365-2796. ; 288:2, s. 248-259
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Abstract
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- Background Cardiac troponin T (cTnT) and I (cTnI) concentrations provide strong prognostic information in anticoagulated patients with atrial fibrillation (AF). Whether the associations between cardiac troponin concentrations and mortality and morbidity differ by sex is not known. Objectives To assess whether men and women have different concentrations and prognostic value of cTnT and cTnI measurements in anticoagulated patients with AF. Methods cTnT and cTnI concentrations were measured with high-sensitivity (hs) assays in EDTA plasma samples obtained from the multicentre ARISTOTLE trial, which randomized patients with AF and at least one risk factor for stroke or systemic embolic event to warfarin or apixaban. Patients were stratified according to sex and the associations between hs-troponin concentrations, and all-cause death, cardiac death, myocardial infarction, stroke or systemic embolic event and major bleeding were assessed in multivariable regression models. Results We found higher cardiac troponin concentrations in men (n = 9649) compared to women (n = 5331), both for hs-cTnT (median 11.8 [Q1-3 8.1-18.0] vs. 9.6 [6.7-14.3] ng L-1, P < 0.001) and hs-cTnI (5.8 [3.4-10.8] vs. 4.9 [3.1-8.8] ng L-1, P < 0.001). Adjusting for baseline demographics, comorbidities and medications, men still had significantly higher hs-troponin concentrations than women. C-reactive protein and N-terminal pro-B-type natriuretic peptide concentrations were higher in female patients. Both hs-cTnT and hs-cTnI concentrations were associated with all clinical outcomes similarly in men and women (p-value for interaction >0.05 for all end-points). Conclusion Men have higher hs-troponin concentrations than women in AF. Regardless of sex, hs-troponin concentrations remain similarly associated with adverse clinical outcomes in anticoagulated patients with AF.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- atrial fibrillation
- biomarker
- troponin
- gender
- prognostication
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Rosjo, H.
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Hijazi, Ziad
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Omland, T.
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Westerbergh, Joh ...
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Lyngbakken, M. N ...
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Alexander, J. H.
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show more...
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Gersh, B. J.
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Granger, C. B.
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Hylek, E. M.
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Lopes, R. D.
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Siegbahn, Agneta ...
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Wallentin, Lars, ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Uppsala University