CVD Risk Could Be Predicted By High-Normal Troponin Levels

A high cardiac troponin concentration within the normal range is associated with an increased risk of cardiovascular disease (CVD) in the general population, according to a recent study.

The researchers conducted a meta-analysis of data from 28 studies (154,052 participants) reporting on cardiac troponin concentration and incidence of coronary heart disease, stroke, and other first-ever CVD outcomes. Study-specific estimates were extracted supplemented with de novo data from the Pravastatin in Elderly Individuals at Risk of Vascular Disease Study (PROSPER).
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Cardiac troponin was detectable in 80% (hs-cTnI: 82.6%; hs-cTnT: 69.7%). In PROSPER, an association was observed between hs-cTnT and CD outcomes. In the meta-analysis, the relative risk, when comparing the top and bottom troponin third, were  1.43 for CVD, 1.67 for fatal CVD, 1.59 for coronary heart disease, and 1.35 for stroke. Associations were stronger in studies measuring hs-cTnT rather than hs-cTnI.

“In the general population, high cardiac troponin concentration within the normal range is associated with increased CVD risk. This association is independent of conventional risk factors, strongest for fatal CVD, and applies to both CHD and stroke,” the researchers concluded.

—Michael Potts

Reference:

Willeit P, Welsh P, Evans JDW, et al. High-sensitivity cardiac troponin concentration and risk of first-ever cardiovascular outcomes in 154,052 participants. JACC. 2017;70(5):558-568