High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: the MORGAM Biomarker Project Scottish Cohort.

Abstract

AIMS:

Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population.

METHODS AND RESULTS:

High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths), 1980 myocardial infarctions, and 797 strokes of all kinds during an average of 20 years follow-up. Detection rate above the limit of detection (LoD) was 74.8% in the overall population and 82.6% in men and 67.0% in women. Troponin I assayed by the high-sensitivity method was associated with future cardiovascular risk after full adjustment such as that individuals in the fourth category had 2.5 times the risk compared with those without detectable troponin I (P < 0.0001). These associations remained significant even for those individuals in whom levels of contemporary-sensitivity troponin I measures were not detectable. Addition of troponin I levels to clinical variables led to significant increases in risk prediction with significant improvement of the c-statistic (P < 0.0001) and net reclassification (P < 0.0001). A threshold of 4.7 pg/mL in women and 7.0 pg/mL in men is suggested to detect individuals at high risk for future cardiovascular events.

CONCLUSION:

Troponin I, measured with a high-sensitivity assay, is an independent predictor of cardiovascular events and might support selection of at risk individuals.

• Authors: Tanja Zeller, Hugh Tunstall-Pedoe, Olli Saarela, Francisco Ojeda, Renate B Schnabel, Tarja Tuovinen, Mark Woodward, Allan Struthers, Maria Hughes, Frank Kee, Veikko Salomaa, Kari Kuulasmaa, Stefan Blankenberg, MORGAM Investigators
• Journal: European heart journal (Eur Heart J) Vol. 35 Issue 5 Pg. 271-81 (Feb 2014) ISSN: 1522-9645 [Electronic] England
• PMID: 24104876 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Troponin I

Topics

• Biomarkers (blood)
• Cardiovascular Diseases (blood, mortality)
• Cohort Studies
• Female
• Humans
• Immunoassay (methods)
• Male
• Middle Aged
• Myocardial Infarction (blood, mortality)
• Prevalence
• Risk Assessment
• Scotland (epidemiology)
• Sex Distribution
• Stroke (blood, mortality)
• Troponin I (blood)