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@ARTICLE{Jansen:144020,
      author       = {H. Jansen and A. Jaensch and B. Schöttker$^*$ and D.
                      Dallmeier and R. Schmucker and H. Brenner$^*$ and W. Koenig
                      and D. Rothenbacher$^*$},
      title        = {{R}epeat {M}easurements of {H}igh {S}ensitivity {T}roponins
                      for the {P}rediction of {R}ecurrent {C}ardiovascular
                      {E}vents in {P}atients {W}ith {E}stablished {C}oronary
                      {H}eart {D}isease: {A}n {A}nalysis {F}rom the {KAROLA}
                      {S}tudy.},
      journal      = {Journal of the American Heart Association},
      volume       = {8},
      number       = {12},
      issn         = {2047-9980},
      address      = {New York, NY},
      publisher    = {Association},
      reportid     = {DKFZ-2019-01571},
      pages        = {e011882},
      year         = {2019},
      abstract     = {Background High-sensitivity cardiac troponins T and I (hs-
                      cTnT and hs- cTnI ) are established biomarkers for
                      myocardial injury and used for diagnostic and prognostic
                      purposes. However, whether repeat measurements improve
                      prediction of recurrent cardiovascular disease ( CVD )
                      events in patients with stable coronary heart disease ( CHD
                      ) after adjustment for several other novel biomarkers
                      remains unclear. Methods and Results We measured both
                      troponins in 873 coronary heart disease patients from the
                      KAROLA (Langzeiterfolge der Kardiologischen
                      Anschlussheilbehandlung) study about 9 weeks after their
                      initial acute event (baseline) and after 12 months,
                      followed them for 12 years, assessed a combined CVD end
                      point, and adjusted for several risk factors. As we found
                      evidence for effect modification, results were stratified
                      according to presence of myocardial infarction at baseline.
                      During follow-up, 186 fatal and non-fatal CVD events
                      occurred. Both baseline and 12-months troponin
                      concentrations were significantly associated with CVD events
                      in patients without myocardial infarction at baseline; in
                      tendency 12 months of troponin showed stronger hazard ratios
                      (hs- cTnT : hazard ratios 1.91 $(95\%$ CI 1.17-3.11) versus
                      baseline values 1.71 $(95\%$ CI 1.08-2.70) and for hs- cTnI
                      : hazard ratio 1.55 $(95\%$ CI 1.05-2.30) versus baseline
                      value 1.22 $(95\%$ CI 0.88-1.68) in the fully and
                      simultaneously adjusted model. Conclusions Both troponins
                      are consistently associated with recurrent cardiovascular
                      events after adjustment for emerging risk factors during
                      follow-up in our study especially evident in patients
                      without myocardial infarction at baseline. Troponin values
                      at 12 months of follow-up showed independent associations
                      with future CVD events in addition to baseline assessments
                      of troponins.},
      cin          = {C070 / C120},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331},
      pnm          = {323 - Metabolic Dysfunction as Risk Factor (POF3-323)},
      pid          = {G:(DE-HGF)POF3-323},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31189389},
      doi          = {10.1161/JAHA.118.011882},
      url          = {https://inrepo02.dkfz.de/record/144020},
}