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Original research
Six-year change in high-sensitivity cardiac troponin T with subsequent stroke risk in the general population
  1. Qiguo Meng1,2,3,4,5,6,
  2. Xiaoqin Gan1,2,3,4,
  3. Cheng Zu5,6,
  4. Yuanyuan Zhang1,2,3,4,
  5. Panpan He1,2,3,4,
  6. Ziliang Ye1,2,3,4,
  7. Xinyue Su5,6,
  8. Yuanxiu Wei5,6,
  9. Xianhui Qin1,2,3,4,5,6
  1. 1Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
  2. 2State Key Laboratory of Organ Failure Research, Guangzhou, Guangdong, China
  3. 3National Clinical Research Center for Kidney Disease, Guangzhou, Guangdong, China
  4. 4Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, Guangdong, China
  5. 5Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
  6. 6Institute of Biomedicine, Anhui Medical University, Hefei, Anhui, China
  1. Correspondence to Dr Xianhui Qin; pharmaqin{at}126.com

Abstract

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.

  • STROKE
  • COHORT STUDIES
  • EPIDEMIOLOGY
  • PUBLIC HEALTH

Data availability statement

No data are available.

https://doi.org/10.1136/jech-2024-222517

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    Data availability statement

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    Footnotes

    • Contributors QM participated in study concept and design, and interpreting the data, composing the statistical dataset, performing the analyses, and writing and revising the manuscript. XG participated in revising the manuscript. CZ participated in revising the manuscript. YZ participated in revising the manuscript. PH participated in revising the manuscript. ZY participated in revising the manuscript. XS participated in revising the manuscript. YW participated in revising the manuscript. XQ participated in study concept and design, interpreting the data and critical revision of the manuscript. XQ is the guarantor.

    • Funding This study was supported by the National Key Research and Development Program of China (2021YFC2500200, 2022YFC2009600 and 2022YFC2009605), National Natural Science Foundation of China (81973133, 82030022, 82330020), Key Technologies R&D Program of Guangdong Province (2023B1111030004), Guangdong Provincial Clinical Research Center for Kidney Disease (2020B1111170013) and the Program of Introducing Talents of Discipline to Universities, 111 Plan (D18005).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.