人群中高敏肌钙蛋白 I 和高敏肌钙蛋白 T 与心脏表型和结局的个体和联合关联：来自达拉斯心脏研究的分析。
Individual and Joint Associations of High-Sensitivity Troponin I and High-Sensitivity Troponin T with Cardiac Phenotypes and Outcomes in the General Population: An Analysis From the Dallas Heart Study.
机构信息
Division of Cardiology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas TX USA.
Department of Internal Medicine University of Texas at Tyler Health Science Center Tyler TX USA.
出版信息
J Am Heart Assoc. 2024 Jul 2;13(13):e034549. doi: 10.1161/JAHA.124.034549. Epub 2024 Jun 6.
BACKGROUND
High-sensitivity troponin I (hs-cTnI) and T (hs-cTnT) provide complementary information regarding cardiovascular disease risk. The explanation for their distinct risk profiles is incompletely understood.
METHODS AND RESULTS
hs-cTnI and hs-cTnT were measured in Dallas Heart Study participants. Associations of hs-cTnI and hs-cTnT with demographics and phenotypes were assessed using linear regression. Associations with incident heart failure, atherosclerotic cardiovascular disease, global cardiovascular disease, and cardiovascular and all-cause mortality were assessed using Cox models. Among 3276 participants (56% women, 50% Black persons, median age 43 years), the correlation between hs-cTnI and hs-cTnT was modest (Spearman rho=0.35). Variables associated with hs-cTnI but not hs-cTnT included hypertension, higher body mass index and total cholesterol, and lower high-density lipoprotein and cholesterol efflux capacity. Older age, male sex, and diabetes were positively associated, and smoking was negatively associated, with hs-cTnT but not hs-cTnI. Hs-cTnI and hs-cTnT were associated with heart failure (hazard ratio [HR] per SD log hs-cTnI 1.53 [95% CI, 1.30-1.81] and HR per SD log hs-cTnT 1.65 [95% CI, 1.40-1.95]), global cardiovascular disease (HR, 1.22 [95% CI, 1.10-1.34] and HR, 1.27 [95% CI, 1.15-1.32]), and all-cause mortality (HR, 1.12 [95% CI, 1.01-1.25], and HR, 1.17 [95% CI, 1.06-1.29]). After adjustment for N-terminal pro-B-type natriuretic peptide and the alternative troponin, both remained associated with heart failure (HR per SD log hs-cTnI 1.32 [95% CI, 1.1-1.58] and HR per log hs-cTnT 1.27 [95% CI, 1.06-1.51]).
CONCLUSIONS
Hs-cTnI and hs-cTnT are modestly correlated, demonstrate differential associations with cardiac and metabolic phenotypes, and provide complementary information regarding heart failure risk.
背景
高敏肌钙蛋白 I（hs-cTnI）和 T（hs-cTnT）在心血管疾病风险方面提供了互补信息。但人们对其不同风险特征的解释还不完全清楚。
方法和结果
在达拉斯心脏研究参与者中测量了 hs-cTnI 和 hs-cTnT。使用线性回归评估 hs-cTnI 和 hs-cTnT 与人口统计学和表型的相关性。使用 Cox 模型评估与心力衰竭、动脉粥样硬化性心血管疾病、全球心血管疾病以及心血管和全因死亡率的相关性。在 3276 名参与者（56%为女性，50%为黑人，中位年龄为 43 岁）中，hs-cTnI 和 hs-cTnT 之间的相关性适度（Spearman rho=0.35）。与 hs-cTnI 相关但与 hs-cTnT 不相关的变量包括高血压、更高的体重指数和总胆固醇，以及更低的高密度脂蛋白胆固醇和胆固醇外排能力。年龄较大、男性和糖尿病与 hs-cTnT 呈正相关，而吸烟与 hs-cTnT 呈负相关，但与 hs-cTnI 无关。hs-cTnI 和 hs-cTnT 与心力衰竭（hs-cTnI 每 SD 对数的 HR 为 1.53[95%CI，1.30-1.81]，hs-cTnT 每 SD 对数的 HR 为 1.65[95%CI，1.40-1.95]）、全球心血管疾病（HR，1.22[95%CI，1.10-1.34]和 HR，1.27[95%CI，1.15-1.32]）和全因死亡率（HR，1.12[95%CI，1.01-1.25]和 HR，1.17[95%CI，1.06-1.29]）相关。在调整了 N 末端脑利钠肽前体和替代肌钙蛋白后，两者仍与心力衰竭相关（hs-cTnI 每 SD 对数的 HR 为 1.32[95%CI，1.10-1.58]，hs-cTnT 每 SD 对数的 HR 为 1.27[95%CI，1.06-1.51]）。
结论
hs-cTnI 和 hs-cTnT 相关性适度，与心脏和代谢表型的相关性存在差异，为心力衰竭风险提供了补充信息。
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