High-sensitivity cardiac troponin T and the risk of incident atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study

Filion, Kristian B.; Agarwal, Sunil K.; Ballantyne, Christie M.; Eberg, Maria; Hoogeveen, Ron C.; Huxley, Rachel R.; Loehr, Laura R.; Nambi, Vijay; Soliman, Elsayed Z.; Alonso, Alvaro

doi:10.1016/j.ahj.2014.10.005

Cited by 73Atrial Fibrillation Management and OutcomesAcute Myocardial Infarction ResearchCardiac electrophysiology and arrhythmias

High-sensitivity cardiac troponin T and the risk of incident atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study

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Filion, Kristian B., Agarwal, Sunil K., Ballantyne, Christie M., Eberg, Maria, Hoogeveen, Ron C., Huxley, Rachel R., Loehr, Laura R., Nambi, Vijay +2 more·2015·American Heart Journal

DOI 10.1016/j.ahj.2014.10.005PMC PMC4429290

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Abstract

Introduction Structural changes in the heart are known risk factors for atrial fibrillation (AF). An association between high-sensitivity cardiac troponin T (hs-cTnT), a marker of myocardial cell damage measured with a high-sensitivity assay, and the risk of AF could have implications for AF risk stratification.Objective To estimate the association between hs-cTnT and the risk of incident AF in the ARIC study, a prospective cohort of middle-aged adults from 4 US communities.Methods Study included 10,584 participants (mean age 62.7 years) free of AF in 1996 to 1998 and followed through 2008. Atrial fibrillation was defined using International Classification of Diseases codes from hospitalizations and death certificates. Participants with undetectable hs-cTnT levels (58%) were assigned the lower limit of measurement (5 ng/L). Net reclassification improvement was used to examine the discriminative ability of hs-cTnT for 10-year AF risk prediction (categories: <5%, 5%-15%, and >15%).Results A total of 920 incident AF cases were observed for 109,227 person-years. After adjustment, a 1-SD difference in ln(hs-cTnT) was associated with a hazard ratio of 1.16 (95% CI 1.10-1.23). Compared with those with undetectable levels, participants with hs-cTnT ≥14 ng/L had a hazard ratio of 1.78 (95% CI 1.43-2.24). Addition of hs-cTnT to known AF predictors did not increase the c statistic appreciably (0.756 vs 0.758) or improve risk stratification (net reclassification improvement 0.4%, 95% CI -1.4% to 2.3%).Conclusions High-sensitivity cTnT level is associated with an increased incidence rate of AF but did not improve risk stratification.

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Although biomarkers such as natriuretic peptides are elevated in AF patients, there is insufficient data to suggest that blood-based parameters are independent markers for AF.
“Although biomarkers such as natriuretic peptides are elevated in AF patients, there is insufficient data to suggest that blood-based parameters are independent markers for AF.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [341]

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Abstract 8460: High-Sensitivity Cardiac Troponin T and the Risk of Incident Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study
Filion, K. B., Agarwal, S. K., Ballantyne, C. M., Hoogeveen, R. C., Huxley, R., Loehr, L. R., Nambi, V., Soliman, E. Z., & Alonso, Á. (2011) · Circulation · doi:10.1161/circ.124.suppl_21.a8460
Self-citation
6‐year change in high sensitivity cardiac troponin T and the risk of atrial fibrillation in the Atherosclerosis Risk in Communities cohort
Li, L., Selvin, E., Hoogeveen, R. C., Soliman, E. Z., Chen, L. Y., Norby, F. L., & Alonso, Á. (2021) · Clinical Cardiology · doi:10.1002/clc.23727 · Cited by 8 · see citing works
Self-citation
High-sensitivity cardiac troponin I and risk of incident atrial fibrillation hospitalisation in an Australian community-based cohort: The Busselton health study
Zhu, K., Hung, J., Divitini, M., Murray, K., Lim, E. M., John, A. S., Walsh, J. P., & Knuiman, M. W. (2018) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2018.05.003 · Cited by 12 · see citing works
Systemic Cardiac Troponin T Associated With Incident Atrial Fibrillation Among Patients With Suspected Stable Angina Pectoris
Vavik, V., Pedersen, E. R., Svingen, G. F. T., Solheim, E., Aakre, K. M., Tell, G. S., Nygard, O. K., & Vikenes, K. (2020) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2020.03.036 · Cited by 2 · see citing works
Cardiac Troponin T Detectable with a Highly Sensitive Assay is Associated with Atrial Fibrillation in the General Population
Anegawa, T., Kai, H., Adachi, H., Fukuda, K., Kajimoto, H., Aoki, Y., Iwamoto, Y., Yasuoka, S., Hirai, Y., & Imaizumi, T. (2011) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2011.06.461

Authors: Filion, K. B., Agarwal, S. K., Ballantyne, C. M., Eberg, M., Hoogeveen, R. C., Huxley, R. R., Loehr, L. R., Nambi, V., Soliman, E. Z., & Alonso, A.
Affiliations: University of Minnesota (US)
Johns Hopkins University (US)
Baylor College of Medicine (US)
Jewish General Hospital (CA)
The University of Queensland (AU)
University of North Carolina at Chapel Hill (US)
Michael E. DeBakey VA Medical Center (US)
Wake Forest University Health Sciences (US)
Corresponding author: Filion, Kristian B.
ORCID: Filion, Kristian B.
Agarwal, Sunil K.
Ballantyne, Christie M.
Hoogeveen, Ron C.
Huxley, Rachel R.
Loehr, Laura R.
Nambi, Vijay
Soliman, Elsayed Z.
Alonso, Alvaro
Venue: American Heart Journal
Publisher: Elsevier BV
Published: 2015-01
Volume: 169
Issue: 1
Pages: 31-38.e3
ISSN: 0002-8703 (ISSN-L)
DOI: 10.1016/j.ahj.2014.10.005
PMC: PMC4429290
OpenAlex: W154375781
Cited by: 73
References: 26
Citations by year: 2026: 5 · 2025: 2 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 8 · 2020: 7 · 2019: 11 · 2018: 4 · 2017: 7 · 2016: 10 · 2015: 2
FWCI: 4.34
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Heart Journal (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
eSpace (Curtin University) (submittedVersion)
Figshare (submittedVersion, cc-by)
Circulation
Funders: National Institutes of Health (5rc1hl099452-02)
Canadian Institutes of Health Research
National Heart, Lung, and Blood Institute (HHSN268201 100012C, HHSN268201100007C, HHSN2682 01100008C, HH-SN-268201100006C, HHSN268201100011C, HHSN268201100005C, HHSN268201100010C, HHSN26820 1100009C, RC1-HL099452)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: high-sensitivity troponin T, atrial fibrillation, incident atrial fibrillation, myocardial injury, atrial fibrillation risk stratification, risk prediction, net reclassification improvement, Atherosclerosis Risk in Communities Study
MeSH terms: Aged, Atrial Fibrillation, Humans, Male, Middle Aged, Risk Factors, Risk Assessment, Troponin T, Atherosclerosis

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High-sensitivity cardiac troponin T and the risk of incident atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study

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