High Sensitivity Troponin T and Risk Stratification in Patients with Atrial Fibrillation during Treatment with Apixaban or Warfarin
Clinical Trials Friday, October 4th, 2013JACC: 10/1.13
Objective Evaluate the prognostic value of high-sensitivity troponin T (hs-TnT) in addition to clinical risk factors and the CHA2DS2VASc risk score in patients with atrial fibrillation (AF).
Background Troponin is a powerful predictor of cardiovascular events and mortality.
Methods 14,897 patients with AF randomized to apixaban or warfarin in the ARISTOTLE trial. The associations between baseline hs-TnT concentrations and outcomes were evaluated using adjusted Cox regression models.
Results hs-TnT was measurable in 99% of patients; 75% had levels above 7.5 ng/L, 50% above 11.0 ng/L and 25% above 16.7 ng/L. During 1.9 years the annual rates of stroke or systemic embolism ranged from 0.87% in the lowest to 2.13% in the highest hs-TnT quartile, adjusted hazard ratio (HR) 1.94 (1.35-2.78), p=0.0010. Read More
