Dataset Information

Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project.

ABSTRACT:

Background and purpose

Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce.

Methods

High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82 881 individuals (median age, 50.7 years; 49.7% men) free of stroke or myocardial infarction at baseline from 9 prospective European community cohorts. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for overoptimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries.

Results

Over a median follow-up of 12.7 years, 3033 individuals were diagnosed with incident nonfatal or fatal stroke (n=1654 ischemic strokes, n=612 hemorrhagic strokes, and n=767 indeterminate strokes). In multivariable regression models, hsTnI concentrations were associated with overall stroke (hazard ratio per 1-SD increase, 1.15 [95% CI, 1.10-1.21]), ischemic stroke (hazard ratio, 1.14 [95% CI, 1.09-1.21]), and hemorrhagic stroke (hazard ratio, 1.10 [95% CI, 1.01-1.20]). Adding hsTnI concentrations to classical cardiovascular risk factors (C indices, 0.809, 0.840, and 0.736 for overall, ischemic, and hemorrhagic stroke, respectively) increased the C index significantly but modestly. In individuals with an intermediate 10-year risk (5%-20%), the net reclassification improvement for overall stroke was 0.038 (P=0.021).

Conclusions

Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort but might be of some value in individuals at an intermediate risk.

SUBMITTER: Camen S

PROVIDER: S-EPMC7447179 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project.

Camen Stephan S Palosaari Tarja T Reinikainen Jaakko J Sprünker Ngoc Anh NA Niiranen Teemu T Gianfagna Francesco F Vishram-Nielsen Julie K K JKK Costanzo Simona S Söderberg Stefan S Palmieri Luigi L Ferrario Marco M Peters Annette A Vartiainen Erkki E Donati Maria Benedetta MB Donfrancesco Chiara C Borchini Rossana R Börschel Christin Susanna CS Giampaoli Simona S Di Castelnuovo Augusto A Magnussen Christina C Kee Frank F Koenig Wolfgang W Blankenberg Stefan S de Gaetano Giovanni G Tunstall-Pedoe Hugh H Rospleszcz Susanne S Jørgensen Torben T Zeller Tanja T Kuulasmaa Kari K Linneberg Allan A Salomaa Veikko V Iacoviello Licia L Schnabel Renate B RB

Stroke 20200819 9

<h4>Background and purpose</h4>Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce.<h4>Methods</h4>High-sensitivity cardiac tr ...[more]

PMID: 32811388

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Dataset Information

Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project.

Background and purpose

Methods

Results

Conclusions

Publications

Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project.

Similar Datasets

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