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

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

Research output: Contribution to journalArticle

Abstract

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 Iwasmeasured in the Scottish HeartHealth ExtendedCohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths),1980myocardial infarctions, and797strokesof all kindsduring anaverageof20years follow-up.Detectionrateabove the limitof detection (LoD)was 74.8% in theoverall populationand 82.6%inmenand 67.0% inwomen.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.

Original languageEnglish (US)
Pages (from-to)271-281
Number of pages11
JournalEuropean heart journal
Volume35
Issue number5
DOIs
StatePublished - Feb 1 2014

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Keywords

  • Cardiovascular risk
  • High-sensitivity assayed troponin I
  • MONICA Risk Genetics Archiving and Monograph (MORGAM)
  • Mortality
  • Scottish Heart Health Extended Cohort (SHHEC)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Zeller, T., Tunstall-Pedoe, H., Saarela, O., Ojeda, F., Schnabel, R. B., Tuovinen, T., Woodward, M., Struthers, A., Hughes, M., Kee, F., Salomaa, V., Kuulasmaa, K., & Blankenberg, S. (2014). High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: The MORGAM Biomarker Project Scottish Cohort. European heart journal, 35(5), 271-281. https://doi.org/10.1093/eurheartj/eht406