Association of high-sensitivity cardiac troponin T with all-cause and cardiovascular mortality in a mobile cohort of older adults aged 70 to 95 years - Results from the AugUR study.

Abstract

It remains unclear whether high-sensitivity cardiac troponin T (hsTnT) independently predicts mortality in older adults. To estimate mortality rate and association of hsTnT with all-cause and cardiovascular death in the older, mobile population. This analysis was conducted in 2055 subjects of the AugUR-study, a prospective population-based cohort study in individuals aged 70 years and older with up to 10-year mortality follow-up. We used Cox proportional hazard models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for association of hsTnT with all-cause, cardiovascular, non-cardiovascular and premature mortality risk. Association results of hsTnT with mortality were reported for tertiles and per 1 standard deviation (SD) of log-transformed values. Participants were 70 to 95 years old with 48% men and 56% with prevalent cardiovascular disease (CVD). In a median follow-up period of 6.0 years, 385 (113 cardiovascular) deaths were recorded. For all-cause mortality, HR was 1.66 [95%CI=1.49-1.85] after adjustment for age and sex (p-value<0.001). For cardiovascular mortality, the effect was more pronounced (HR=2.17 [95%CI=1.79-2.63]; p < 0.001). The association between hsTnT with non-cardiovascular mortality was also significant (HR=1.61 [95%CI=1.41-1.83]; p < 0.001). In a full model adjusting for factors influencing mortality and hsTnT levels, in participants with prevalent CVD, hsTnT showed still association with cardiovascular mortality (HR=1.65 [95%CI=1.30-2.10]; p < 0.001) but also with non-cardiovascular mortality (HR=1.32 [95%CI=1.10-1.58]; p < 0.01). Elevated levels of hsTnT were associated with increased cardiovascular and non-cardiovascular mortality risk in an old-aged population. Measurement of hsTnT in subjects with prevalent CVD may help identify individuals at high risk for mortality.