医学
内科学
冲程(发动机)
人口
心脏病学
肌钙蛋白复合物
肌钙蛋白
心肌梗塞
环境卫生
机械工程
工程类
作者
Qiguo Meng,Xiaoqin Gan,Cheng Zu,Yang Yang,Panpan He,Ziliang Ye,Xinyue Su,Yuanxiu Wei,Xianhui Qin
标识
DOI:10.1136/jech-2024-222517
摘要
Background The association between change in high-sensitivity cardiac troponin T (hs-cTnT) and stroke risk in the general population remains unknown. We aimed to assess the association of a 6-year change in hs-cTnT with incident stroke and its subtypes in the general American adult population. Methods 8675 middle-aged adults without prevalent cardiovascular disease from the Atherosclerosis Risk in Communities study were included. Hs-cTnT was measured at two time points (visits 2 and 4), 6 years apart. The relative percentage change of hs-cTnT was defined as hs-cTnT at visit 4 minus that at visit 2, divided by hs-cTnT at visit 2. The study outcome was incident stroke and its subtypes. All data were analysed in 2023. Results Over a median follow-up of 20.1 years, 682 incident strokes occurred, including 593 ischaemic and 89 haemorrhagic strokes. For absolute change, using low/low group as reference category, the low/high (adjusted HR 1.44, 95% CI 1.03 to 2.02) and high/high (adjusted HR 1.47, 95% CI 0.93 to 2.34) groups were associated with higher risk of stroke. Moreover, the relative percentage change in hs-cTnT with stroke followed an inverted L-shaped association, levelling off at about 75% increase in hs-cTnT (P for nonlinearity=0.009). Compared with those with ≤50% change in hs-cTnT, participants with >50% increase in hs-cTnT had a higher risk of stroke (adjusted HR 1.30, 95% CI 1.03 to 1.64). Similar results were found for ischaemic stroke. No significant association was found for haemorrhagic stroke. Conclusion Temporal increase in hs-cTnT was associated with a higher risk of incident total and ischaemic stroke in the general population.
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