{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T23:01:29Z","timestamp":1768777289881,"version":"3.49.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Elderly women are at high risk of coronary heart disease (\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              ) and heart failure. High\u2010sensitivity assays allow detection of cardiac troponin I (hsTnI) well below diagnostic cutoffs for acute coronary syndrome. We investigated the association between these levels with future cardiac events in community\u2010based ambulant white women aged over 70\u00a0years initially recruited for a 5\u2010year randomized, controlled trial of calcium supplements.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This was a prospective study of 1081 elderly women without clinical\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              at baseline (1998) or hsTnI above the diagnostic cutoffs for acute coronary syndrome with 14.5\u2010year follow\u2010up hospitalization and mortality (events). Two hundred forty\u2010three (22%) women had\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              events, 163 (15%) myocardial infarction or\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              death (hard\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              ), and 109 (10%) heart failure. In 99.6% of available serum samples, hsTnI was above the level of detection (median, 4.5\u00a0ng\/L; interquartile range, 3.6\u20135.8). After adjusting for Framingham risk factors, each\n              <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n              natural log\u2010transformed hsTnI increase was associated with an increased hazard for\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              (hazard ratio, 1.34; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.18\u20131.53;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) hard\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              (hazard ratio, 1.51; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.29\u20131.76;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and heart failure (hazard ratio, 1.65; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.36\u20131.99;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Step\u2010wise increases in relative hazards were observed with increasing quartiles of hsTnI (\n              <jats:italic>P<\/jats:italic>\n              for trend, &lt;0.001), whereas the addition of hsTnI to conventional risk factors modestly improved discrimination indices: Harrell's c\u2010statistic, net reclassification, and integrated discrimination (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiac troponin I is independently associated with future cardiac events in elderly women without apparent clinical manifestations. The addition of cardiac troponin I to conventional risk factors may modestly improve risk prediction in this setting.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.004174","type":"journal-article","created":{"date-parts":[[2017,7,31]],"date-time":"2017-07-31T00:10:11Z","timestamp":1501459811000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Association Between High\u2010Sensitivity Cardiac Troponin I and Cardiac Events in Elderly Women"],"prefix":"10.1161","volume":"6","author":[{"given":"Joshua R.","family":"Lewis","sequence":"first","affiliation":[{"name":"Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia"},{"name":"Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia"},{"name":"Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai H.","family":"Lim","sequence":"additional","affiliation":[{"name":"Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia"},{"name":"Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Germaine","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Abbs","sequence":"additional","affiliation":[{"name":"PathWest, Sir Charles Gairdner Hospital, Perth, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia"},{"name":"Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ee M.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia"},{"name":"PathWest, Sir Charles Gairdner Hospital, Perth, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L.","family":"Prince","sequence":"additional","affiliation":[{"name":"Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia"},{"name":"Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192667"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.2.180"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437741.48606.98"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.03.022"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011670"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1112570"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2012.08.001"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2010.05.014"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.192716"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.12.048"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht406"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0090063"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2013.129"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.968792"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.06.043"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.8.869"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.699579"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1071\/AH080766"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.1999.tb01297.x"},{"key":"e_1_3_5_21_2","volume-title":"Monitoring the Incidence of Cardiovascular Disease in Australia","author":"Jamrozik K","year":"2001","unstructured":"Jamrozik K, Dobson A, Hobbs M, McElduff P, Ring I, D'Este K, Crome M. Monitoring the Incidence of Cardiovascular Disease in Australia. Canberra, ACT: AIHW;2001. CVD Series 17."},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2008.00269.x"},{"key":"e_1_3_5_23_2","volume-title":"Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the Recommendations of the Ninth Revision Conference, 1975, and Adopted by the Twenty\u2010Ninth World Health Assembly","author":"World Health Organization","year":"1977","unstructured":"World Health Organization . Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the Recommendations of the Ninth Revision Conference, 1975, and Adopted by the Twenty\u2010Ninth World Health Assembly. 1975 revision. ed. Geneva: World Health Organization; 1977."},{"key":"e_1_3_5_24_2","volume-title":"ICD\u201010: International Statistical Classification of Diseases and Related Health Problems: Tenth Revision","author":"World Health Organization","year":"2004","unstructured":"World Health Organization . ICD\u201010: International Statistical Classification of Diseases and Related Health Problems: Tenth Revision. 2nd ed. Geneva: World Health Organization; 2004.","edition":"2"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4508"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2929"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.129437"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014522"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2014.234369"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1708"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2014.08.016"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-301779"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2014.222778"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.005264"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws206"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197810262991705"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.004174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:52:23Z","timestamp":1715597543000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.004174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,2]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8,2]]}},"alternative-id":["10.1161\/JAHA.116.004174"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.004174","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,2]]},"assertion":[{"value":"2016-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004174"}}