• Navin Suthahar, Laura M G Meems, Dirk J van Veldhuisen, Joan E Walter, Ron T Gansevoort, Stephane Heymans, Blanche Schroen, Pim van der Harst, Jenny E Kootstra-Ros, Vanessa van Empel, Christian Mueller, Bakker Stephan J L SJL University of Groningen, University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, the Netherlands., and Rudolf A de Boer.
• University of Groningen, University Medical Center Groningen, Department of Cardiology, the Netherlands. Electronic address: n.suthahar@umcg.nl.
• Mayo Clin. Proc. 2020 Jun 1; 95 (6): 1158-1168.

ObjectiveTo evaluate associations of high-sensitivity cardiac troponin-T (cTnT) with cardiovascular disease (CVD), heart failure (HF), and mortality in community-dwelling women and men.Participants And MethodsA total of 8226 adults from the Prevention of Renal and Vascular End-stage Disease (PREVEND) cohort (1997-1998) were enrolled in a prospective observational study (mean age: 49 years; 50.2% women). Sex-specific associations of cTnT levels with future clinical outcomes were evaluated using adjusted Cox-regression models.ResultsMeasurable cTnT levels (≥3 ng/L) were detected in 1102 women (26.7%) and in 2396 men (58.5%). Baseline cTnT levels were associated with a greater risk of developing CVD in women than men [Hazard ratio (HRwomen), 1.48 per unit increase in log2-cTnT; 95% CI, 1.21 to 1.81 vs HRmen, 1.20; 95% CI, 1.07 to 1.35; Pinteraction<.001]. Similar sex-related differences were observed for HF (Pinteraction= .005) and mortality (Pinteraction= .008). Further, compared with referent category (cTnT <3 ng/L), women with cTnT levels greater than or equal to 6 ng/L had a significantly increased risk for CVD (HR, 2.30; 95% CI, 1.45 to 3.64), HF (HR, 2.86; 95% CI, 1.41 to 5.80), and mortality (HR, 2.65; 95% CI, 1.52 to 4.61), whereas men with cTnT levels greater than or equal to 6 ng/L had a significantly increased risk only for CVD (HR, 1.51; 95% CI, 1.07 to 2.13).ConclusionBaseline cTnT levels were associated with future CVD, HF, and mortality in both sexes, and these associations were stronger in women. Future studies are needed to determine the value of cTnT in early diagnosis of CVD, particularly in women.Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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