Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide. / Lyngbæk, Stig; Winkel, Per; Gøtze, Jens P; Kastrup, Jens; Gluud, Christian; Kolmos, Hans Jørn; Kjøller, Erik; Jensen, Gorm Boje; Hansen, Jørgen Fischer; Hildebrandt, Per; Hilden, Jørgen; CLARICOR Trial Group.

In: European Journal of Preventive Cardiology, Vol. 21, No. 10, 2014, p. 1275-1284.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Lyngbæk, S, Winkel, P, Gøtze, JP, Kastrup, J, Gluud, C, Kolmos, HJ, Kjøller, E, Jensen, GB, Hansen, JF, Hildebrandt, P, Hilden, J & CLARICOR Trial Group 2014, 'Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide', European Journal of Preventive Cardiology, vol. 21, no. 10, pp. 1275-1284. https://doi.org/10.1177/2047487313492099

APA

Lyngbæk, S., Winkel, P., Gøtze, J. P., Kastrup, J., Gluud, C., Kolmos, H. J., Kjøller, E., Jensen, G. B., Hansen, J. F., Hildebrandt, P., Hilden, J., & CLARICOR Trial Group (2014). Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide. European Journal of Preventive Cardiology, 21(10), 1275-1284. https://doi.org/10.1177/2047487313492099

Vancouver

Lyngbæk S, Winkel P, Gøtze JP, Kastrup J, Gluud C, Kolmos HJ et al. Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide. European Journal of Preventive Cardiology. 2014;21(10):1275-1284. https://doi.org/10.1177/2047487313492099

Author

Lyngbæk, Stig ; Winkel, Per ; Gøtze, Jens P ; Kastrup, Jens ; Gluud, Christian ; Kolmos, Hans Jørn ; Kjøller, Erik ; Jensen, Gorm Boje ; Hansen, Jørgen Fischer ; Hildebrandt, Per ; Hilden, Jørgen ; CLARICOR Trial Group. / Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide. In: European Journal of Preventive Cardiology. 2014 ; Vol. 21, No. 10. pp. 1275-1284.

Bibtex

@article{199d00f9de2e4fa68c38526952e36555,

title = "Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide",

abstract = "AIMS: Low prevalence of detectable cardiac troponin in healthy people and low-risk patients previously curtailed its use. With a new high-sensitive cardiac troponin assay (hs-cTnT), concentrations below conventional detection may have prognostic value, notably in combination with N-terminal pro-B-type natriuretic peptide (NT-pro-BNP).METHODS AND RESULTS: Biomarker concentrations were determined from serum obtained at enrolment in the CLARICOR trial involving 4197 patients with stable coronary artery disease (CAD) followed for 2.6 years. Serum hs-cTnT was detectable (above 3 ng/l) in 78% and above the conventional 99th percentile (13.5 ng/l) in 23%. Across all levels of hs-cTnT there was a graded increase in the risk of cardiovascular death after adjustment for known prognostic indicators: hazard ratio (HR) per unit increase in the natural logarithm of the hs-cTnT level, 1.49; 95% confidence interval (CI), 1.23-1.81; similarly for all-cause mortality (HR 1.48, 95% CI 1.29-1.70) and myocardial infarction (HR 1.37, 95% CI 1.13-1.67). Increasing values of hs-cTnT were associated with increased mortality across all values of NT-pro-BNP, but this was particularly prominent when NT-pro-BNP >400 ng/l.CONCLUSIONS: In patients with stable CAD, any detectable hs-cTnT level is significantly associated with all-cause mortality, cardiovascular death, and myocardial infarction after adjustment for traditional risk factors and NT-pro-BNP. Excess mortality is particularly pronounced in patients with NT-pro-BNP >400 ng/l.",

author = "Stig Lyngb{\ae}k and Per Winkel and G{\o}tze, {Jens P} and Jens Kastrup and Christian Gluud and Kolmos, {Hans J{\o}rn} and Erik Kj{\o}ller and Jensen, {Gorm Boje} and Hansen, {J{\o}rgen Fischer} and Per Hildebrandt and J{\o}rgen Hilden and {CLARICOR Trial Group}",

note = "{\textcopyright} The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.",

year = "2014",

doi = "10.1177/2047487313492099",

language = "English",

volume = "21",

pages = "1275--1284",

journal = "European Journal of Preventive Cardiology",

issn = "2047-4873",

publisher = "SAGE Publications",

number = "10",

}

RIS

TY - JOUR

T1 - Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide

AU - Lyngbæk, Stig

AU - Winkel, Per

AU - Gøtze, Jens P

AU - Kastrup, Jens

AU - Gluud, Christian

AU - Kolmos, Hans Jørn

AU - Kjøller, Erik

AU - Jensen, Gorm Boje

AU - Hansen, Jørgen Fischer

AU - Hildebrandt, Per

AU - Hilden, Jørgen

AU - CLARICOR Trial Group

PY - 2014

Y1 - 2014

N2 - AIMS: Low prevalence of detectable cardiac troponin in healthy people and low-risk patients previously curtailed its use. With a new high-sensitive cardiac troponin assay (hs-cTnT), concentrations below conventional detection may have prognostic value, notably in combination with N-terminal pro-B-type natriuretic peptide (NT-pro-BNP).METHODS AND RESULTS: Biomarker concentrations were determined from serum obtained at enrolment in the CLARICOR trial involving 4197 patients with stable coronary artery disease (CAD) followed for 2.6 years. Serum hs-cTnT was detectable (above 3 ng/l) in 78% and above the conventional 99th percentile (13.5 ng/l) in 23%. Across all levels of hs-cTnT there was a graded increase in the risk of cardiovascular death after adjustment for known prognostic indicators: hazard ratio (HR) per unit increase in the natural logarithm of the hs-cTnT level, 1.49; 95% confidence interval (CI), 1.23-1.81; similarly for all-cause mortality (HR 1.48, 95% CI 1.29-1.70) and myocardial infarction (HR 1.37, 95% CI 1.13-1.67). Increasing values of hs-cTnT were associated with increased mortality across all values of NT-pro-BNP, but this was particularly prominent when NT-pro-BNP >400 ng/l.CONCLUSIONS: In patients with stable CAD, any detectable hs-cTnT level is significantly associated with all-cause mortality, cardiovascular death, and myocardial infarction after adjustment for traditional risk factors and NT-pro-BNP. Excess mortality is particularly pronounced in patients with NT-pro-BNP >400 ng/l.

AB - AIMS: Low prevalence of detectable cardiac troponin in healthy people and low-risk patients previously curtailed its use. With a new high-sensitive cardiac troponin assay (hs-cTnT), concentrations below conventional detection may have prognostic value, notably in combination with N-terminal pro-B-type natriuretic peptide (NT-pro-BNP).METHODS AND RESULTS: Biomarker concentrations were determined from serum obtained at enrolment in the CLARICOR trial involving 4197 patients with stable coronary artery disease (CAD) followed for 2.6 years. Serum hs-cTnT was detectable (above 3 ng/l) in 78% and above the conventional 99th percentile (13.5 ng/l) in 23%. Across all levels of hs-cTnT there was a graded increase in the risk of cardiovascular death after adjustment for known prognostic indicators: hazard ratio (HR) per unit increase in the natural logarithm of the hs-cTnT level, 1.49; 95% confidence interval (CI), 1.23-1.81; similarly for all-cause mortality (HR 1.48, 95% CI 1.29-1.70) and myocardial infarction (HR 1.37, 95% CI 1.13-1.67). Increasing values of hs-cTnT were associated with increased mortality across all values of NT-pro-BNP, but this was particularly prominent when NT-pro-BNP >400 ng/l.CONCLUSIONS: In patients with stable CAD, any detectable hs-cTnT level is significantly associated with all-cause mortality, cardiovascular death, and myocardial infarction after adjustment for traditional risk factors and NT-pro-BNP. Excess mortality is particularly pronounced in patients with NT-pro-BNP >400 ng/l.

U2 - 10.1177/2047487313492099

DO - 10.1177/2047487313492099

M3 - Journal article

C2 - 23723326

VL - 21

SP - 1275

EP - 1284

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

SN - 2047-4873

IS - 10

ER -

ID: 135187085

Department of Public Health