Abstract 13238: Clinical Utility Of Hs-Tni In Healthy Thai Subjects With Intermediate Cardiovascular Risk
Abstract only Introduction: In European countries, hs-cTnI is approved for risk stratification in general population. Whether this indication can be applied to Thai population is unknown. We test the utility of hs-cTnI as a risk stratification tool for incident cardiovascular disease among Thai subj...
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Published in | Circulation (New York, N.Y.) Vol. 144; no. Suppl_1 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
16.11.2021
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Online Access | Get full text |
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Summary: | Abstract only
Introduction:
In European countries, hs-cTnI is approved for risk stratification in general population. Whether this indication can be applied to Thai population is unknown. We test the utility of hs-cTnI as a risk stratification tool for incident cardiovascular disease among Thai subjects with intermediate cardiovascular (CV) risk and without previous cardiovascular disease.
Hypothesis:
Hs-cTnI can be used as a risk stratification tool in Thai subject who has intermediate cardiovascular risk.
Methods:
Data were retrieved from 1,757 subjects who had intermediate CV risk (7.5%-19.9%) and had no known CV disease from the electricity generating authority of Thailand (EGAT) study during the year 2007-2009. High-sensitive Troponin I was tested using the Abbot ARCHITECT i2000 SR system. Hs-cTnI was categorized into low, intermediate and high risk using gendered-specific cut-offs points. Major adverse cardiac event (MACE), defined as a composite of CV death, non-fatal myocardial infarction and non-fatal stroke, was collected and confirmed by medical record until 2017-2019. Survival analysis and net reclassification index (NRI) analysis were performed.
Results:
A total of 1,757 subjects had complete data for analysis. Mean age was 57-year-old, 77% were male. After 10 years, 88 CV event (5%) occurred. Median hs-cTnI was 3 (2.2, 4.1) mg/dL. The event rate was significantly highest in high-risk group of hs-cTnI (14%), followed by intermediate (6.4%) and low risk group (4.3%). Multivariate analysis adjusted for conventional risk factor from Thai CV risk score showed that hs-cTnI is an independent risk factor for MACE (HR 1.02, 95% CI 1.01 to 1.03). For the high-risk group, compared to low risk group, hazard ratio was 3.24, 95% CI 1.73 to 6.07 (p value for trend < 0.001). The addition of hsTnI information to prognostic model yielded an NRI of 0.11 (p-value 0.006).
Conclusions:
In this intermediate CV risk population, elevation of hs-cTnI is not uncommon. Hs-cTnI is an independent risk factor for cardiovascular death, myocardial infarction and stroke. Hs-cTnI significantly improves the reclassification as shown by NRI. Hs-cTnI can be used as a risk stratification tool in Thai subject who has intermediate cardiovascular risk. |
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ISSN: | 0009-7322 1524-4539 |
DOI: | 10.1161/circ.144.suppl_1.13238 |