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dc.contributor.authorEvans, Jonathan DWen
dc.contributor.authorDobbin, Stephen JHen
dc.contributor.authorPettit, Stephen Jen
dc.contributor.authorDi Angelantonio, Emanueleen
dc.contributor.authorWilleit, Peteren
dc.date.accessioned2018-02-05T11:22:25Z
dc.date.available2018-02-05T11:22:25Z
dc.date.issued2018-03en
dc.identifier.issn2213-1779
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/271639
dc.description.abstractBackground: Identification of individuals at high risk of heart failure and early risk factor modification with medications such as ACE inhibitors may delay the onset of heart failure. High-sensitivity cardiac troponin (hs-cTn) has been suggested as a prognostic marker for the incidence of first-ever heart failure in asymptomatic individuals. Methods: Pubmed, Embase and Web of Science were systematically searched for prospective cohort studies published before January 2017 that reported associations between hs-cTn and incident heart failure in individuals without baseline heart failure. Study-specific multivariable adjusted hazard ratios were pooled using random-effects meta-analysis. Results: Data were collated from sixteen studies with a total of 67,063 individuals and 4,165 incident heart failure events. Average age was 57 years and 47% were female. Study quality was high (Newcastle-Ottawa score: 8.2/9). In a comparison of participants in the top third with those in the bottom third of baseline values of hs-cTn, the pooled multivariable adjusted hazard ratio for incident heart failure was 2.09 (95% CI 1.76-2.48, p<0.001). Between-study heterogeneity was high with an I2 of 80%. Hazard ratios were similar in men and women (2.29 [1.64-3.21] vs 2.18 [1.68-2.81]), with hs-cTnI and hs-cTnT (2.09 [1.53-2.85] vs 2.11 [1.69-2.63]) and across other study-level characteristics. Further adjustment for B-type natriuretic peptides yielded a similar hazard ratio of 2.08 (1.64-2.65). Assay of hs-cTn in addition to conventional risk factors provided improvements in the c-index of 1-3%. Conclusions: Available prospective studies indicate a strong association of hs-cTn with the risk of first-ever heart failure and significant improvements in heart failure prediction.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherElsevier
dc.subjectHumansen
dc.subjectMyocardial Infarctionen
dc.subjectTroponinen
dc.subjectAgeden
dc.subjectMiddle Ageden
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectHeart Failureen
dc.subjectBiomarkersen
dc.titleHigh-Sensitivity Cardiac Troponin and New-Onset Heart Failure: A Systematic Review and Meta-Analysis of 67,063 Patients With 4,165 Incident Heart Failure Events.en
dc.typeArticle
prism.endingPage197
prism.issueIdentifier3en
prism.publicationDate2018en
prism.publicationNameJACC. Heart failureen
prism.startingPage187
prism.volume6en
dc.identifier.doi10.17863/CAM.18633
dcterms.dateAccepted2017-11-11en
rioxxterms.versionofrecord10.1016/j.jchf.2017.11.003en
rioxxterms.versionAM*
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-03en
dc.contributor.orcidDobbin, Stephen JH [0000-0002-9111-0242]
dc.contributor.orcidDi Angelantonio, Emanuele [0000-0001-8776-6719]
dc.contributor.orcidWilleit, Peter [0000-0002-1866-7159]
dc.identifier.eissn2213-1787
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMRC (MR/L003120/1)
pubs.funder-project-idBritish Heart Foundation (RG/08/014/24067)
rioxxterms.freetoread.startdate2019-01-10


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