In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
Abstract:
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.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.144.suppl_1.13238
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
1466401-X
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