Li L, Selvin E, Hoogeveen RC, et al. - An increased risk of incident atrial fibrillation (AF) was observed in relation to six-year increase in circulating high sensitivity cardiac troponin T (hs-cTnT).

• This prospective cohort study included 8431 participants from the Atherosclerosis Risk in Communities study.

• At visit 2 and 4, hs-cTnT change was defined as undetectable (<5 ng/L), detectable (≥5 ng/L, <14 ng/L), or elevated (≥14 ng/L).

• In participants with undetectable hs-cTnT at visit 2, 1.28 was the multivariable hazard ratio (HR) of AF in those with detectable or increased hs-cTnT at visit 4 vs those in which hs-cTnT remained undetectable.

• Among those with detectable hs-cTnT at visit 2, vs those who remained in the detectable hs-cTnT group, a lower AF risk (HR 0.74) linked with reduction to undetectable at visit 4 while higher AF risk (HR 1.30) with increment to elevated was evident.

• No significant improvement in the C-statistic or substantial net reclassification index was achieved on adding hs-cTnT change to the main model with baseline hs-cTnT.