Seemingly healthy 71-year-old men with minor elevations of cardiac troponin I and at risk of premature death in CVD have elevated levels of NT-proBNP: report from the ULSAM study.
BACKGROUND
Hypersensitive cardiac troponin I (cTnI) assays detect even minor elevations of cTnI. Previous findings identifying a group of seemingly healthy elderly men with very minor elevations of cTnI have shown that these men were at risk of premature cardiovascular death.


OBJECTIVE
To study the association between cTnI concentrations and cardiovascular risk factors and subclinical cardiac and renal target organ damage in a community-based sample of elderly men.


METHODS
Biomarkers reflecting glucose and lipid metabolism, renal function, cardiac function and inflammation were measured in the ULSAM study (n = 1205, mean age 71 years). The participants were placed in three subgroups based on the cTnI concentrations: a low group with cTnI <0.02 microg/L, an intermediate group with cTnI between 0.02 and 0.039 microg/L and a high group with cTnI >0.039 microg/L.


RESULTS
In the entire cohort of 71-year-old men, most markers of glucose and lipid metabolism, renal function, inflammation and NT-proBNP were significantly related to the concentrations of cTnI, and most obviously in the high-cTnI group. In subjects with no signs of CVD (cardiovascular disease), only levels of NT-proBNP related to cTnI, and with the highest NT-proBNP levels in the high-cTnI group (p<0.01). A multiple regression analysis showed that NT-proBNP was independently related to cTnI (p<0.001).


CONCLUSIONS
Measurement of cardiac troponins with highly sensitive assays identifies those at risk of premature CVD death who have hitherto remained unrecognized. The associated elevations of NT-proBNP in these participants support the fact that these elevations reflect ongoing pathological processes in the myocardium.
Venge
Per
P
Department of Medical Sciences, University of Uppsala, Uppsala, Sweden. per.venge@akademiska.se
Arnlöv
Johan
J
Zethelius
Björn
B
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality; D015331:Cohort Studies; D006801:Humans; D007668:Kidney / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D009206:Myocardium / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012044:Regression Analysis; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain