1. Highly sensitive serum cardiac troponin T and cardiovascular events in patients with systemic lupus erythematosus (TROPOPLUS study)
- Author
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Drifa Belhadi, Nathalie Morel, Lionel Galicier, François Chasset, Nicolas Limal, Véronique Le Guern, Thomas Papo, Alexis Mathian, Micheline Pha, Sébastien de Almeida Chaves, Fanny Saidoune, Cédric Laouénan, Olivier Aumaître, Françoise Sarrot-Reynauld, Camille Chenevier-Gobeaux, Zahir Amoura, Felix Ackermann, Laurent Perard, Jean Emmanuel Kahn, Olivier Fain, Karim Sacre, D. Rouzaud, Julie Chezel, Pierre Duhaut, Nathalie Costedoat-Chalumeau, Pascale Ghillani-Dalbin, Hélène Desmurs-Clavel, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département d'épidémiologie, biostatistique et recherche clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CIC epidémiologie clinique/ essais cliniques, Hôpital Bichat - Claude Bernard, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service de dermatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHU Saint-Antoine [AP-HP], Hopital Saint-Louis [AP-HP] (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Ambroise Paré [AP-HP], Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Saint Joseph Saint Luc, Hôpital Michallon, CHU Clermont-Ferrand, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Henri Mondor, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), and Hôpital Foch [Suresnes]
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,cardiovascular events ,03 medical and health sciences ,0302 clinical medicine ,Troponin T ,Rheumatology ,Troponin complex ,Risk Factors ,Interquartile range ,Median follow-up ,Internal medicine ,Humans ,Lupus Erythematosus, Systemic ,Medicine ,Pharmacology (medical) ,Dyslipidemias ,030203 arthritis & rheumatology ,Systemic lupus erythematosus ,business.industry ,Hazard ratio ,Age Factors ,lupus ,Middle Aged ,medicine.disease ,Highly sensitive ,Cardiovascular Diseases ,biomarker ,Biomarker (medicine) ,Female ,France ,cardiac troponin T ,business ,Biomarkers ,Follow-Up Studies - Abstract
Objective Identification of biological markers able to better stratify cardiovascular risks in SLE patients is needed. We aimed to determine whether serum cardiac troponin T (cTnT) levels measured with a highly sensitive assay [high sensitivity cTnT (HS-cTnT)] may predict cardiovascular events (CVEs) in SLE. Method All SLE patients included between 2007 and 2010 in the randomized, double-blind, placebo-controlled, multicentre PLUS trial were screened. Patients with no past history of CVE at inclusion and a follow-up period of >20 months were analysed. HS-cTnT concentration was measured using the electrochemiluminescence method on serum collected at PLUS inclusion. The primary outcome was the incident CVE. Factors associated with the primary outcome were identified and multivariate analysis was performed. Results Overall, 442 SLE patients (of the 573 included in the PLUS study) were analysed for the primary outcome with a median follow up of 110 (interquartile range: 99–120) months. Among them, 29 (6.6%) experienced at least one CVE that occurred at a median of 67 (interquartile range: 31–91) months after inclusion. Six out of 29 patients had more than one CVE. In the multivariate analysis, dyslipidaemia, age and HS-cTnT were associated with the occurrence of CVE. Kaplan–Meier analysis showed that a concentration of HS-cTnT > 4.27 ng/l at inclusion increased by 2.7 [hazard ratio 2.7 (95% CI: 1.3, 5.6), P =0.0083] the risk of CVE in SLE. Conclusion HS-cTnT measured in serum is the first identified biomarker independently associated with incident CVE in SLE patients.
- Published
- 2020