Prevalence and determinants of troponin T elevation in the general population.
BACKGROUND
The prevalence and determinants of cardiac troponin T (cTnT) elevation in the general population are unknown, and the significance of minimally increased cTnT remains controversial. Our objective was to determine the prevalence and determinants of cTnT elevation in a large, representative sample of the general population.


RESULTS
cTnT was measured from stored plasma samples in 3557 subjects of the Dallas Heart Study, a population-based sample. cTnT elevation (> or =0.01 microg/L) was correlated with clinical variables and cardiac MRI findings. The sample weight-adjusted prevalence of cTnT elevation in the general population was 0.7%. In univariable analyses, cTnT elevation was associated with older age, black race, male sex, coronary artery calcium by electron beam CT, a composite marker of congestive heart failure (CHF), left ventricular hypertrophy (LVH), diabetes mellitus (DM), and chronic kidney disease (CKD) (P<0.001 for each). Subjects with minimally increased (0.01 to 0.029 microg/L) and increased (> or =0.03 microg/L) cTnT had a similar prevalence of these characteristics. In multivariable logistic regression analysis, LVH, CHF, DM, and CKD were independently associated with cTnT elevation.


CONCLUSIONS
In the general population, cTnT elevation is rare in subjects without CHF, LVH, CKD, or DM, suggesting that the upper limit of normal for the immunoassay should be <0.01 microg/L. Even minimally increased cTnT may represent subclinical cardiac injury and have important clinical implications, a hypothesis that should be tested in longitudinal outcome studies.
Wallace
Thomas W
TW
Donald W. Reynolds Cardiovascular Clinical Research Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-9047, USA.
Abdullah
Shuaib M
SM
Drazner
Mark H
MH
Das
Sandeep R
SR
Khera
Amit
A
McGuire
Darren K
DK
Wians
Frank
F
Sabatine
Marc S
MS
Morrow
David A
DA
de Lemos
James A
JA
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood; D007674:Kidney Diseases / Q000097:blood; D008297:Male; D008875:Middle Aged; D020107:Troponin T / Q000097:blood*
D020107:Troponin T