High-sensitivity cardiac troponin I and risk of incident atrial fibrillation hospitalisation in an Australian community-based cohort: The Busselton health study

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Abstract

Objective: The identification of individuals at risk of atrial fibrillation (AF) remains a challenge. We investigated whether high-sensitive cardiac troponin I (hs-cTnI) is an independent predictor of incident atrial fibrillation (AF) hospitalisation in an Australian community-based cohort. Methods: Serum hs-cTnI was measured in 1641 men and 2189 women in the Busselton Health Study 1994/1995 Cohort aged 25–84 years at baseline. Data on incident AF hospitalisation over 20 years follow-up were obtained by data linkage. Results: Hs-cTnI was detectable (>1.2 ng/L) in 65.5% of participants (males 81.4%, females 53.6%) at baseline. There were 179 (10.9%) AF events in men and 208 (9.5%) in women. In the multivariable-adjusted model, hs-cTnI was a significant predictor of AF event with hazard ratio 1.21 (95% CI 1.11–1.32, P < 0.001) in the whole cohort, 1.17 (95% CI 1.01–1.35, P = 0.037) in men and 1.22 (95% CI 1.08–1.37, P = 0.001) in women for a doubling of baseline hs-cTnI. In women, a graded and significant increase in risk of AF was observed across hs-cTnI categories from ≥1.3 ng/L, whereas in men only the highest category (≥6.0 ng/L) had significantly increased risk compared with individuals with hs-cTnI ≤1.2 ng/L. Addition of categorical hs-cTnI to standard risk factors for AF improved risk estimation in females (C-statistic increment 0.006, P = 0.04) but not males (increment 0.005, P = 0.12) and net reclassification improvement was not significant in either sex. Conclusions: High-sensitive cTnI level is an independent predictor of incident AF hospitalisation in a community-based cohort but does not improve risk stratification.

Original languageEnglish
Pages (from-to)20-25
Number of pages6
JournalClinical Biochemistry
Volume58
DOIs
Publication statusPublished - 1 Aug 2018

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Troponin I
Atrial Fibrillation
Hospitalization
Health
Information Storage and Retrieval
Hazards
Statistics
Serum

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@article{0d112115579d422b979dc5804e88eaeb,
title = "High-sensitivity cardiac troponin I and risk of incident atrial fibrillation hospitalisation in an Australian community-based cohort: The Busselton health study",
abstract = "Objective: The identification of individuals at risk of atrial fibrillation (AF) remains a challenge. We investigated whether high-sensitive cardiac troponin I (hs-cTnI) is an independent predictor of incident atrial fibrillation (AF) hospitalisation in an Australian community-based cohort. Methods: Serum hs-cTnI was measured in 1641 men and 2189 women in the Busselton Health Study 1994/1995 Cohort aged 25–84 years at baseline. Data on incident AF hospitalisation over 20 years follow-up were obtained by data linkage. Results: Hs-cTnI was detectable (>1.2 ng/L) in 65.5{\%} of participants (males 81.4{\%}, females 53.6{\%}) at baseline. There were 179 (10.9{\%}) AF events in men and 208 (9.5{\%}) in women. In the multivariable-adjusted model, hs-cTnI was a significant predictor of AF event with hazard ratio 1.21 (95{\%} CI 1.11–1.32, P < 0.001) in the whole cohort, 1.17 (95{\%} CI 1.01–1.35, P = 0.037) in men and 1.22 (95{\%} CI 1.08–1.37, P = 0.001) in women for a doubling of baseline hs-cTnI. In women, a graded and significant increase in risk of AF was observed across hs-cTnI categories from ≥1.3 ng/L, whereas in men only the highest category (≥6.0 ng/L) had significantly increased risk compared with individuals with hs-cTnI ≤1.2 ng/L. Addition of categorical hs-cTnI to standard risk factors for AF improved risk estimation in females (C-statistic increment 0.006, P = 0.04) but not males (increment 0.005, P = 0.12) and net reclassification improvement was not significant in either sex. Conclusions: High-sensitive cTnI level is an independent predictor of incident AF hospitalisation in a community-based cohort but does not improve risk stratification.",
keywords = "Atrial fibrillation, Busselton Health Study, Community-based cohort, High-sensitivity cardiac troponin I, Risk prediction",
author = "Kun Zhu and Joseph Hung and Mark Divitini and Kevin Murray and Lim, {Ee Mun} and {St John}, Andrew and Walsh, {John P.} and Matthew Knuiman",
year = "2018",
month = "8",
day = "1",
doi = "10.1016/j.clinbiochem.2018.05.003",
language = "English",
volume = "58",
pages = "20--25",
journal = "Clinical Biochemistry",
issn = "0009-9120",
publisher = "Pergamon",

}

TY - JOUR

T1 - High-sensitivity cardiac troponin I and risk of incident atrial fibrillation hospitalisation in an Australian community-based cohort

T2 - The Busselton health study

AU - Zhu, Kun

AU - Hung, Joseph

AU - Divitini, Mark

AU - Murray, Kevin

AU - Lim, Ee Mun

AU - St John, Andrew

AU - Walsh, John P.

AU - Knuiman, Matthew

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Objective: The identification of individuals at risk of atrial fibrillation (AF) remains a challenge. We investigated whether high-sensitive cardiac troponin I (hs-cTnI) is an independent predictor of incident atrial fibrillation (AF) hospitalisation in an Australian community-based cohort. Methods: Serum hs-cTnI was measured in 1641 men and 2189 women in the Busselton Health Study 1994/1995 Cohort aged 25–84 years at baseline. Data on incident AF hospitalisation over 20 years follow-up were obtained by data linkage. Results: Hs-cTnI was detectable (>1.2 ng/L) in 65.5% of participants (males 81.4%, females 53.6%) at baseline. There were 179 (10.9%) AF events in men and 208 (9.5%) in women. In the multivariable-adjusted model, hs-cTnI was a significant predictor of AF event with hazard ratio 1.21 (95% CI 1.11–1.32, P < 0.001) in the whole cohort, 1.17 (95% CI 1.01–1.35, P = 0.037) in men and 1.22 (95% CI 1.08–1.37, P = 0.001) in women for a doubling of baseline hs-cTnI. In women, a graded and significant increase in risk of AF was observed across hs-cTnI categories from ≥1.3 ng/L, whereas in men only the highest category (≥6.0 ng/L) had significantly increased risk compared with individuals with hs-cTnI ≤1.2 ng/L. Addition of categorical hs-cTnI to standard risk factors for AF improved risk estimation in females (C-statistic increment 0.006, P = 0.04) but not males (increment 0.005, P = 0.12) and net reclassification improvement was not significant in either sex. Conclusions: High-sensitive cTnI level is an independent predictor of incident AF hospitalisation in a community-based cohort but does not improve risk stratification.

AB - Objective: The identification of individuals at risk of atrial fibrillation (AF) remains a challenge. We investigated whether high-sensitive cardiac troponin I (hs-cTnI) is an independent predictor of incident atrial fibrillation (AF) hospitalisation in an Australian community-based cohort. Methods: Serum hs-cTnI was measured in 1641 men and 2189 women in the Busselton Health Study 1994/1995 Cohort aged 25–84 years at baseline. Data on incident AF hospitalisation over 20 years follow-up were obtained by data linkage. Results: Hs-cTnI was detectable (>1.2 ng/L) in 65.5% of participants (males 81.4%, females 53.6%) at baseline. There were 179 (10.9%) AF events in men and 208 (9.5%) in women. In the multivariable-adjusted model, hs-cTnI was a significant predictor of AF event with hazard ratio 1.21 (95% CI 1.11–1.32, P < 0.001) in the whole cohort, 1.17 (95% CI 1.01–1.35, P = 0.037) in men and 1.22 (95% CI 1.08–1.37, P = 0.001) in women for a doubling of baseline hs-cTnI. In women, a graded and significant increase in risk of AF was observed across hs-cTnI categories from ≥1.3 ng/L, whereas in men only the highest category (≥6.0 ng/L) had significantly increased risk compared with individuals with hs-cTnI ≤1.2 ng/L. Addition of categorical hs-cTnI to standard risk factors for AF improved risk estimation in females (C-statistic increment 0.006, P = 0.04) but not males (increment 0.005, P = 0.12) and net reclassification improvement was not significant in either sex. Conclusions: High-sensitive cTnI level is an independent predictor of incident AF hospitalisation in a community-based cohort but does not improve risk stratification.

KW - Atrial fibrillation

KW - Busselton Health Study

KW - Community-based cohort

KW - High-sensitivity cardiac troponin I

KW - Risk prediction

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U2 - 10.1016/j.clinbiochem.2018.05.003

DO - 10.1016/j.clinbiochem.2018.05.003

M3 - Article

VL - 58

SP - 20

EP - 25

JO - Clinical Biochemistry

JF - Clinical Biochemistry

SN - 0009-9120

ER -