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. 2013 Feb;23(2):66-73.
doi: 10.1016/j.annepidem.2012.11.004. Epub 2012 Dec 8.

Troponin T, B-type natriuretic peptide, C-reactive protein, and cause-specific mortality

Oludamilola W Oluleye  1 , Aaron R Folsom, Vijay Nambi, Pamela L Lutsey, Christie M Ballantyne; ARIC Study Investigators
Affiliations

Troponin T, B-type natriuretic peptide, C-reactive protein, and cause-specific mortality

Oludamilola W Oluleye et al. Ann Epidemiol. 2013 Feb.

Abstract

Purpose: We sought to evaluate the associations of high-sensitivity troponin T (Hs-TnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and high sensitivity C-reactive protein (Hs-CRP) with mortality from any cause, cardiovascular disease (CVD), coronary heart disease (CHD), stroke, cancer, and respiratory disease in the Atherosclerosis Risk in Communities cohort.

Methods: We included 11,193 participants aged 54 to 74 years, initially free of the conditions being studied, and who had biomarkers measured. Participants were followed for a mean of 9.9 years.

Results: Hazard ratios (HR), adjusted for multiple risk factors, for mortality in participants in the highest Hs-TnT category compared with those with undetectable levels were: Total 3.42 (95% confidence interval [CI], 2.75-4.26); CVD, 7.34 (95% CI, 4.64-11.6); CHD, 6.06 (95% CI, 2.91-12.6); stroke, 3.31 (95% CI, 1.26-8.66); cancer, 1.60 (95% CI, 1.08-2.38); and respiratory, 3.85 (95% CI, 1.39-10.7). Comparing the highest NT-proBNP quintile with those in the lowest quintile, the adjusted HRs for mortality were: Total, 3.05 (95% CI, 2.46-3.77); CVD, 7.48 (95% CI, 4.67-12.0); CHD, 4.07 (95% CI, 2.07-7.98); and stroke, 10.4 (95% CI, 2.26-47.7). Comparing extreme Hs-CRP quintiles, the adjusted HRs for mortality were: Total, 1.61 (95% CI, 1.32-1.97); CVD, 1.76 (95% CI, 1.19-2.62); and respiratory, 3.36 (95% CI, 1.34-8.45). Having multiple markers elevated simultaneously greatly increased cause-specific mortality risks.

Conclusions: Greater levels of Hs-TnT, NT-proBNP and Hs-CRP are associated with increased risk of death, not just from CVD, but also from some noncardiovascular causes.

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Figures

Figure 1
Figure 1
Participant Flow Chart a Total Cardiovascular disease deaths: ICD 9 code 401- 459 or ICD-10 code I10- I99 b Coronary Heart disease deaths: ICD 9 code 410- 414 or ICD-10 code I20- I25 c Stroke deaths: ICD 9 code 430- 438 or ICD-10 code I60- I69 d Cancer deaths: ICD 9 code 140- 239 or ICD-10 code C00- D48
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