4.7 Article

Sex Differences in Cardiac Troponin I and T and the Prediction of Cardiovascular Events in the General Population

期刊

CLINICAL CHEMISTRY
卷 67, 期 10, 页码 1351-1360

出版社

OXFORD UNIV PRESS INC
DOI: 10.1093/clinchem/hvab109

关键词

sex; cardiac troponin; risk factors; cardiovascular events

资金

  1. Stratified Medicine Grant from the Chief Scientist Office of the Scottish Government Health Directorates [ASM/14/1]
  2. Chief Scientist Office of the Scottish Government Health Directorates [CZD/16/6]
  3. Scottish Funding Council [HR03006]
  4. Health Data Research UK
  5. HDR UK Ltd [HDR-5012]
  6. UK Medical Research Council, Engineering and Physical Sciences Research Council
  7. Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government)
  8. Public Health Agency (Northern Ireland)
  9. British Heart Foundation
  10. Wellcome Trust
  11. Kootstra Talent Fellowship [19.1314]
  12. MRC University Unit Programme [MC_UU_00007/10]
  13. British Heart Foundation through a Senior Clinical Research Fellowship [FS/16/14/32023, RG/20/10/34966, RE/18/5/34216]

向作者/读者索取更多资源

Cardiac troponin concentrations differ in women and men, with women having stronger predictive ability for cardiovascular events. Sex-specific approaches are needed to provide equivalent risk prediction.
BACKGROUND: Cardiac troponin concentrations differ in women and men, but how this influences risk prediction and whether a sex-specific approach is required is unclear. We evaluated whether sex influences the predictive ability of cardiac troponin I and T for cardiovascular events in the general population. METHODS: High-sensitivity cardiac troponin (hs-cTn) I and T were measured in the Generation Scotland Scottish Family Health Study of randomly selected volunteers drawn from the general population between 2006 and 2011. Cox-regression models evaluated associations between hs-cTnI and hs-cTnT and the primary outcome of cardiovascular death, myocardial infarction, or stroke. RESULTS: In 19501 (58% women, mean age 47years) participants, the primary outcome occurred in 2.7% (306/11375) of women and 5.1% (411/8126) of men during the median follow-up period of 7.9 (IQR, 7.1-9.2) years. Cardiac troponin I and T concentrations were lower in women than men (P<0.001 for both), and both were more strongly associated with cardiovascular events in women than men. For example, at a hs-cTnI concentration of 10ng/L, the hazard ratio relative to the limit of blank was 9.7 (95% CI 7.6-12.4) and 5.6 (95% CI 4.7-6.6) for women and men, respectively. The hazard ratio for hs-cTnT at a concentration of 10ng/L relative to the limit of blank was 3.7 (95% CI 3.1-4.3) and 2.2 (95% CI 2.0-2.5) for women and men, respectively. CONCLUSIONS: Cardiac troponin concentrations differ in women and men and are stronger predictors of cardiovascular events in women. Sex-specific approaches are required to provide equivalent risk prediction.

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