Association of high-sensitivity cardiac troponin T with all-cause and cardiovascular mortality in older adults with low lean mass: A 14.6-year longitudinal study

Qiang Qu; Yanping Shi; Qixin Guo; Xin Yue; Lu Chen; Jinyu Sun; Ziqi Chen; Jinjing Shi; Iokfai Cheang; Xu Zhu; Wenming Yao; Rongrong Gao; Xinli Li; Yanli Zhou; Haifeng Zhang; Shengen Liao

doi:10.1016/j.archger.2023.105140

Association of high-sensitivity cardiac troponin T with all-cause and cardiovascular mortality in older adults with low lean mass: A 14.6-year longitudinal study

Arch Gerontol Geriatr. 2024 Jan:116:105140. doi: 10.1016/j.archger.2023.105140. Epub 2023 Jul 31.

Authors

Qiang Qu¹, Yanping Shi², Qixin Guo¹, Xin Yue¹, Lu Chen², Jinyu Sun¹, Ziqi Chen¹, Jinjing Shi¹, Iokfai Cheang¹, Xu Zhu¹, Wenming Yao¹, Rongrong Gao¹, Xinli Li¹, Yanli Zhou¹, Haifeng Zhang³, Shengen Liao⁴

Affiliations

¹ Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
² Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 26 Daoqian Street, Suzhou 215002, China.
³ Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 26 Daoqian Street, Suzhou 215002, China; Department of Cardiology, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing 210029, China.
⁴ Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China. Electronic address: shengenliao@163.com.

PMID: 37542916
DOI: 10.1016/j.archger.2023.105140

Abstract

Background: Current evidence on the association between high-sensitivity cardiac troponin T (hs-cTnT) levels and mortality in elderly sarcopenic patients is limited. This study aimed to investigate the association of serum hs-cTnT concentrations with all-cause and cardiovascular mortality in older adults with low lean mass (LLM) and without baseline cardiovascular disease.

Methods: This prospective cohort study included 369 older adults (representing 3.2 million people) from the National Health and Nutrition Examination Survey 1999-2004. Individuals were linked to national death records until 31 December 2019. The weighted Kaplan-Meier analysis, Cox proportional hazards models, restricted cubic spline models, stratified analysis, interaction analysis, and sensitivity analysis were performed to examine the association between hs-cTnT levels and mortality in older adults with LLM.

Results: During 4697 person-years of follow-up (median duration, 14.6 years), 228 (65.6%) deaths were documented, including 56 (15.8%) deaths from cardiovascular disease. Individuals with a hs-cTnT level of ≥14 ng/L had 2.1- and 4.4-fold higher risks of all-cause and cardiovascular mortality, respectively. Compared with the lowest quartile, the fourth quartile of hs-cTnT levels was significantly associated with 3.1- and 6.4-fold higher risks of all-cause and cardiovascular mortality, respectively. Each one standard deviation increase in natural log-transformed hs-cTnT levels significantly and linearly increased the risks of all-cause and cardiovascular mortality by 39% and 61%, respectively. Stratified and sensitivity analyses confirmed the robustness of the association.

Conclusions: In this nationally representative cohort of US older adults with LLM, higher serum hs-cTnT concentrations were significantly associated with increased risks of all-cause and cardiovascular mortality.

Keywords: All-cause mortality; Cardiovascular mortality; High-sensitivity cardiac troponin T; Low lean mass; Sarcopenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomarkers
Cardiovascular Diseases*
Humans
Longitudinal Studies
Nutrition Surveys
Prospective Studies
Troponin T*

Substances

Troponin T
Biomarkers