Prevalence and pathophysiological mechanisms of elevated cardiac troponin I levels in a population-based sample of elderly subjects.
OBJECTIVE
To evaluate the prevalence of cardiac troponin I (cTnI) elevation in an elderly community population and the association of cTnI levels with cardiovascular risk factors, vascular inflammation, atherosclerosis, cardiac performance, and areas indicative of infarcted myocardium identified by cardiac magnetic resonance imaging.


RESULTS
cTnI elevation defined as cTnI levels >0.01 microg/L (Access AccuTnI, Beckman Coulter) was found in 21.8% of the study participants (n = 1005). cTnI > 0.01 microg/L was associated with cardiovascular high-risk features, the burden of atherosclerosis in the carotid arteries, left-ventricular mass, and impaired left-ventricular systolic function. No associations were found between cTnI and inflammatory activity, diastolic dysfunction, or myocardial scars. Male gender (OR 1.6; 95% CI 1.1-2.4), ischaemic ECG changes (OR 1.7; 95% CI 1.1-2.7), and NT-pro-brain natriuretic peptide levels (OR 1.4; 95% CI 1.1-1.7) independently predicted cTnI > 0.01 microg/L. cTnI > 0.01 microg/L correlated also to an increased cardiovascular risk according to the Framingham risk score.


CONCLUSIONS
cTnI > 0.01 microg/L is relatively common in elderly subjects and is associated with cardiovascular high-risk features and impaired cardiac performance. Cardiac troponin determined by a highly sensitive assay might thus serve as an instrument for the identification of subjects at high cardiovascular risk in general populations.
Eggers
Kai M
KM
Department of Medical Sciences, Cardiology, Uppsala University Hospital, S-751 85 Uppsala, Sweden. kai.eggers@ucr.uu.se
Lind
Lars
L
Ahlström
Håkan
H
Bjerner
Tomas
T
Ebeling Barbier
Charlotte
C
Larsson
Anders
A
Venge
Per
P
Lindahl
Bertil
B
D000368:Aged; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis*; D017023:Coronary Angiography / Q000379:methods; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D009206:Myocardium / Q000378:metabolism*; D018570:Risk Assessment; D019210:Troponin I / Q000097:blood* / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis*
D019210:Troponin I; D052279:Creatine Kinase, MB Form