# Hoog-sensitief troponine, statinetherapie en risico op coronairlijden

*geplaatst 2016-12-27 · Cholesterol · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2016.10.020 · https://hartvaat.nl/2016/12/27/hoog-sensitief-troponine-statinetherapie-en-risico-op-coronairlijden/*

Studie naar de relatie tussen hoog-sensitief troponine, statinegebruik en het risico op coronairlijden. Onderzoekt troponine als biomarker voor subclinische myocardschade en therapiemonitoring.

## English: High-Sensitivity Cardiac Troponin, Statin Therapy, and Risk of Coronary Heart Disease.

This study explored the relationship between high-sensitivity troponin levels, statin use, and coronary heart disease risk, investigating whether troponin can serve as a biomarker to guide statin therapy initiation.

## Abstract (original, from the publication)

BACKGROUND: Cardiac troponin is an independent predictor of cardiovascular mortality in individuals without symptoms or signs of cardiovascular disease. The mechanisms for this association are uncertain, and a role for troponin testing in the prevention of coronary heart disease has yet to be established. OBJECTIVES: This study sought to determine whether troponin concentration could predict coronary events, be modified by statins, and reflect response to therapy in a primary prevention population. METHODS: WOSCOPS (West of Scotland Coronary Prevention Study) randomized men with raised low-density lipoprotein cholesterol and no history of myocardial infarction to pravastatin 40 mg once daily or placebo for 5 years. Plasma cardiac troponin I concentration was measured with a high-sensitivity assay at baseline and at 1 year in 3,318 participants. RESULTS: Baseline troponin was an independent predictor of myocardial infarction or death from coronary heart disease (hazard ratio [HR]: 2.3; 95% confidence interval [CI]: 1.4 to 3.7) for the highest (≥5.2 ng/l) versus lowest (≤3.1 ng/l) quarter of troponin (p < 0.001). There was a 5-fold greater reduction in coronary events when troponin concentrations decreased by more than a quarter, rather than increased by more than a quarter, for both placebo (HR: 0.29; 95% CI: 0.12 to 0.72 vs. HR: 1.95; 95% CI: 1.09 to 3.49; p < 0.001 for trend) and pravastatin (HR: 0.23; 95% CI: 0.10 to 0.53 vs. HR: 1.08; 95% CI: 0.53 to 2.21; p < 0.001 for trend). Pravastatin reduced troponin concentration by 13% (10% to 15%; placebo adjusted, p < 0.001) and doubled the number of men whose troponin fell more than a quarter (p < 0.001), which identified them as having the lowest risk for future coronary events (1.4% over 5 years). CONCLUSIONS: Troponin concentration predicts coronary events, is reduced by statin therapy, and change at 1 year is associated with future coronary risk independent of cholesterol lowering. Serial troponin measurements have major potential to assess cardiovascular risk and monitor the impact of therapeutic interventions.

Auteurs: Ian Ford, Anoop S V Shah, Ruiqi Zhang, David A McAllister, Fiona E Strachan, Muriel Caslake, David E Newby, Chris J Packard, Nicholas L Mills

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2016.10.020. Bijgewerkt 2026-07-03T13:25:48Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.