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. 2016 Apr;62(4):623-30.
doi: 10.1373/clinchem.2015.250811. Epub 2016 Mar 2.

High-Sensitivity Cardiac Troponin I Is a Strong Predictor of Cardiovascular Events and Mortality in the AGES-Reykjavik Community-Based Cohort of Older Individuals

Ingunn Thorsteinsdottir  1 , Thor Aspelund  2 , Elias Gudmundsson  3 , Gudny Eiriksdottir  3 , Tamara B Harris  4 , Lenore J Launer  4 , Vilmundur Gudnason  2 , Per Venge  5
Affiliations

High-Sensitivity Cardiac Troponin I Is a Strong Predictor of Cardiovascular Events and Mortality in the AGES-Reykjavik Community-Based Cohort of Older Individuals

Ingunn Thorsteinsdottir et al. Clin Chem. 2016 Apr.

Abstract

Background: The objective of this study was to investigate the predictive power of a high-sensitivity cardiac troponin I (hs-cTnI) assay for cardiovascular events and mortality in a large population of older community dwellers.

Methods: Blood was collected from 5764 individuals (age 66-98 years) during the period of 2002-2006 and the outcome as to all-cause death and incidence of cardiovascular disease (CVD) and coronary heart disease (CHD) followed up to 10 years. hs-cTnI (Abbott) was measured in serum to assess the association of this marker with CVD, CHD and death, and finally, to compare the results with conventional risk factors by multivariable statistical analysis.

Results: The median (interquartile range) concentrations of hs-cTnI were 8.4 ng/L (5.6-14.2 ng/L) and 5.3 ng/L (3.8-8.1 ng/L) in men (2416) and women (3275), respectively, and the concentrations increased linearly with age. Outcomes as to all-cause death and incidence of CVD and CHD were significantly associated with increasing concentrations of hs-cTnI beginning well below the 99th percentile concentrations. The associations with outcome remained after adjustments for conventional risk factors and were similar in men and women.

Conclusions: Our findings suggest that hs-cTnI reflects the status of the myocardium even in seemingly healthy individuals and that the measurements of hs-cTnI may be useful for primary prediction of heart disease; this should form the basis for future prospective clinical trials for determining whether measuring hs-cTnI can be used in the prevention of CVD/CHD.

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Figures

Figure 1
Figure 1
Distributions of high-sensitive cardiac troponin I by sex, presented for a maxium value of 30 ng/L
Figure 2
Figure 2
All-cause death, rates per 100,000 person years in men vs women, stratified by categories of high-sensitivity cardiac troponin I (hs-cTnI). Values for hs-cTnI in ng/L. Bars are standard error
Figure 3
Figure 3
Quartile analysis of hs-cTnI by gender showing probability of: A) all-cause death, B) cardiovascular diseases, C) coronary heart disease Values for high-sensitivity cardiac troponin I. Quartile 1; (1.2–4.4 ng/L); Quartile 2; (4.5–6.3 ng/L); Quartile 3; (6.4–10.5 ng/L); Quartile 4; (10.6–1692 ng/L)
Figure 3
Figure 3
Quartile analysis of hs-cTnI by gender showing probability of: A) all-cause death, B) cardiovascular diseases, C) coronary heart disease Values for high-sensitivity cardiac troponin I. Quartile 1; (1.2–4.4 ng/L); Quartile 2; (4.5–6.3 ng/L); Quartile 3; (6.4–10.5 ng/L); Quartile 4; (10.6–1692 ng/L)
Figure 3
Figure 3
Quartile analysis of hs-cTnI by gender showing probability of: A) all-cause death, B) cardiovascular diseases, C) coronary heart disease Values for high-sensitivity cardiac troponin I. Quartile 1; (1.2–4.4 ng/L); Quartile 2; (4.5–6.3 ng/L); Quartile 3; (6.4–10.5 ng/L); Quartile 4; (10.6–1692 ng/L)
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