■在一般人群和各种高危人群中,高敏心肌肌钙蛋白T(hs-cTnT)与心血管疾病(CVD)风险相关。
■本研究的目的是精确描述急性缺血性卒中或短暂性脑缺血发作后患者hs-cTnT与CVD风险的相关性。
■我们对STROKE-CARD试验(NCT02156778)的数据进行了事后分析,一项针对急性缺血性卒中或短暂性脑缺血发作(ABCD2评分≥3分)患者的疾病管理计划的务实随机对照试验.我们测量了入院时的hs-cTnT(RocheElecsys,检测限5ng/L)和复合CVD结果的定量HR(即,中风,心肌梗塞,CVD死亡)根据年龄调整,性别,既往冠心病,之前的心力衰竭,糖尿病,吸烟,收缩压,和低密度和高密度脂蛋白胆固醇。
■在1,687名患者中(平均年龄,69.3±13.7岁;40.7%为女性),hs-cTnT检测率为80.7%。hs-cTnT中位数为10ng/L(IQR:6-18ng/L)。中位随访时间为12.1个月,110例患者发生CVD事件。hs-cTnT水平与CVD风险的关系呈对数线性,多变量校正HR为1.40(95%CI:1.15-1.70;P<0.001)每1-SD较高的对数转换hs-cTnT值。当进一步调整其他潜在混杂因素和临床相关亚组时,关联强度相似。卒中的相应结果特异性HR为1.33(95%CI:1.06-1.68;P=0.016),1.28(95%CI:0.69-2.37;P=0.430)用于心肌梗死,CVD死亡1.98(95%CI:1.43-2.73;P<0.001),全因死亡为1.93(95%CI:1.54-2.41;P<0.001)。
■高hs-cTnT与缺血性卒中和短暂性脑缺血发作患者CVD风险增加相关。
UNASSIGNED: High-sensitivity cardiac troponin T (hs-cTnT) is associated with cardiovascular disease (CVD) risk in general and various high-risk populations.
UNASSIGNED: The purpose of this study was to precisely characterize the association of hs-cTnT with CVD risk in patients following acute ischemic stroke or transient ischemic attack.
UNASSIGNED: We conducted post hoc analyses of data from the STROKE-CARD trial (NCT02156778), a pragmatic randomized controlled trial of a disease management program in patients with acute ischemic stroke or transient ischemic attack (ABCD2 score ≥3). We measured hs-cTnT on admission (Roche Elecsys, detection limit 5 ng/L) and quantified HRs for a composite CVD outcome (ie, stroke, myocardial infarction, CVD death) adjusted for age, sex, prior coronary heart disease, prior heart failure, diabetes, smoking, systolic blood pressure, and low- and high-density-lipoprotein cholesterol.
UNASSIGNED: Among 1,687 patients (mean age, 69.3 ± 13.7 years; 40.7% female), hs-cTnT was detectable in 80.7%. Median hs-cTnT was 10 ng/L (IQR: 6-18 ng/L). Over a median follow-up of 12.1 months, 110 patients had a CVD event. The association of hs-cTnT level with CVD risk was of log-linear shape, with a multivariable-adjusted HR of 1.40 (95% CI: 1.15-1.70; P < 0.001) per 1-SD higher log-transformed hs-cTnT value. The strength of association was similar when further adjusted for other potential confounders and across clinically relevant subgroups. Corresponding outcome-specific HRs were 1.33 (95% CI: 1.06-1.68; P = 0.016) for stroke, 1.28 (95% CI: 0.69-2.37; P = 0.430) for myocardial infarction, 1.98 (95% CI: 1.43-2.73; P < 0.001) for CVD death, and 1.93 (95% CI: 1.54-2.41; P < 0.001) for all-cause death.
UNASSIGNED: High hs-cTnT is associated with increased CVD risk in ischemic stroke and transient ischemic attack patients.