Cardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI)
Abstract Cardiac Troponin I (cTnI) could be used to identify individuals at elevated risk of cardiac death in lung cancer (LC) screening settings. In a population-based, randomized LC screening trial in Germany (“LUSI” study) serum cTnI was measured by high-sensitivity assay in blood samples collect...
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Nature Portfolio
2024-03-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-57889-z |
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| author | Francisco O. Cortés-Ibáñez Theron Johnson Mario Mascalchi Verena Katzke Stefan Delorme Rudolf Kaaks |
| author_facet | Francisco O. Cortés-Ibáñez Theron Johnson Mario Mascalchi Verena Katzke Stefan Delorme Rudolf Kaaks |
| author_sort | Francisco O. Cortés-Ibáñez |
| collection | DOAJ |
| description | Abstract Cardiac Troponin I (cTnI) could be used to identify individuals at elevated risk of cardiac death in lung cancer (LC) screening settings. In a population-based, randomized LC screening trial in Germany (“LUSI” study) serum cTnI was measured by high-sensitivity assay in blood samples collected at baseline, and categorized into unquantifiable/low (< 6 ng/L), intermediate (≥ 6–15 ng/L), and elevated (≥ 16 ng/L). Cox proportional-hazard models were used to estimate risk of all-cause and cardiac mortality with cTnI levels. After exclusion criteria, 3653 participants were included for our analyses, of which 82.4% had low, 12.8% intermediate and 4.8% elevated cTnI, respectively. Over a median follow up of 11.87 years a total of 439 deaths occurred, including 67 caused by cardiac events. Within the first 5 years after cTnI measurement, intermediate or elevated cTnI levels showed approximately 1.7 (HR = 1.69 [95% CI 0.57–5.02) and 4.7-fold (HR = 4.66 [1.73–12.50]) increases in risk of cardiac death relative to individuals with unquantifiable/low cTnI, independently of age, sex, smoking and other risk factors. Within this time interval, a risk model based on age, sex, BMI, smoking history and cTnI showed a combined area under the ROC curve (AUC) of 73.6 (58.1–87.3), as compared to 70.4 (53.3–83.5) for a model without cTnI. Over the time interval of > 5–10 years after blood donation, the relative risk associations with cTnI and were weaker. cTnI showed no association with mortality from any other (non-cardiac) cause. Our findings show that cTnI may be of use for identifying individuals at elevated risk specifically of short-term cardiac mortality in the context of LC screening. |
| first_indexed | 2024-04-24T16:17:37Z |
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| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-24T16:17:37Z |
| publishDate | 2024-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-70d594c2941c425f8776076556437bb42024-03-31T11:20:35ZengNature PortfolioScientific Reports2045-23222024-03-011411910.1038/s41598-024-57889-zCardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI)Francisco O. Cortés-Ibáñez0Theron Johnson1Mario Mascalchi2Verena Katzke3Stefan Delorme4Rudolf Kaaks5Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ)Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ)Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ)Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ)Division of Radiology, German Cancer Research Center (DKFZ)Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ)Abstract Cardiac Troponin I (cTnI) could be used to identify individuals at elevated risk of cardiac death in lung cancer (LC) screening settings. In a population-based, randomized LC screening trial in Germany (“LUSI” study) serum cTnI was measured by high-sensitivity assay in blood samples collected at baseline, and categorized into unquantifiable/low (< 6 ng/L), intermediate (≥ 6–15 ng/L), and elevated (≥ 16 ng/L). Cox proportional-hazard models were used to estimate risk of all-cause and cardiac mortality with cTnI levels. After exclusion criteria, 3653 participants were included for our analyses, of which 82.4% had low, 12.8% intermediate and 4.8% elevated cTnI, respectively. Over a median follow up of 11.87 years a total of 439 deaths occurred, including 67 caused by cardiac events. Within the first 5 years after cTnI measurement, intermediate or elevated cTnI levels showed approximately 1.7 (HR = 1.69 [95% CI 0.57–5.02) and 4.7-fold (HR = 4.66 [1.73–12.50]) increases in risk of cardiac death relative to individuals with unquantifiable/low cTnI, independently of age, sex, smoking and other risk factors. Within this time interval, a risk model based on age, sex, BMI, smoking history and cTnI showed a combined area under the ROC curve (AUC) of 73.6 (58.1–87.3), as compared to 70.4 (53.3–83.5) for a model without cTnI. Over the time interval of > 5–10 years after blood donation, the relative risk associations with cTnI and were weaker. cTnI showed no association with mortality from any other (non-cardiac) cause. Our findings show that cTnI may be of use for identifying individuals at elevated risk specifically of short-term cardiac mortality in the context of LC screening.https://doi.org/10.1038/s41598-024-57889-zTroponinBiomarkersLung cancer screeningMyocardial infarctionMortalityRisk assessment |
| spellingShingle | Francisco O. Cortés-Ibáñez Theron Johnson Mario Mascalchi Verena Katzke Stefan Delorme Rudolf Kaaks Cardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI) Scientific Reports Troponin Biomarkers Lung cancer screening Myocardial infarction Mortality Risk assessment |
| title | Cardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI) |
| title_full | Cardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI) |
| title_fullStr | Cardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI) |
| title_full_unstemmed | Cardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI) |
| title_short | Cardiac troponin I as predictor for cardiac and other mortality in the German randomized lung cancer screening trial (LUSI) |
| title_sort | cardiac troponin i as predictor for cardiac and other mortality in the german randomized lung cancer screening trial lusi |
| topic | Troponin Biomarkers Lung cancer screening Myocardial infarction Mortality Risk assessment |
| url | https://doi.org/10.1038/s41598-024-57889-z |
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