title: Feasibility and usefulness of troponin I testing in insurance medicine.
abstract: OBJECTIVE
  Ascertain the prevalence of elevated Troponin I levels in applicants for insurance to assess the utility of routine measurement of Troponin I in this population.
  
  
  BACKGROUND
  Patients presenting with chest pain, who are determined not to be experiencing an acute coronary event, but are noted to have increased levels of Troponin have higher mortality rates than a control population. Elevated levels of Tropoins in the general population are also associated with increase in all cause mortality. Therefore elevated Troponin levels in asymptomatic individuals could be considered a cardiac risk marker.
  
  
  METHODS
  Blood samples from Insurance applicants and Health & Wellness participants were analyzed for Troponin I by the Siemens ADVIA Centaur immunoanalyzer. Since such samples are in transit for a day, we determined the rate of degradation of Troponin I on 24-hour storage at room temperature and extrapolated the time-zero values.
  
  
  RESULTS
  About 1.5% (10 of 697) of the patients had Troponin levels above 0.04 ng/mL. This rate is higher than would be expected in a healthy general population. Three samples (0.43%) had levels > 0.06 ng/mL, which would be considered elevated and indicative of myocardial injury.
  
  
  CONCLUSIONS
  Given the low percentage Troponin I elevations in the general population applying for life insurance, it may not be cost effective to routinely measure Troponin I levels in blood specimens submitted for insurance purposes, except for high value policies. It may be prudent collect data on Troponin I levels in Insurance applicants for better defining the risk models of cardiovascular disease.
authors.forename: Lindsey J
authors.initials: LJ
authors.lastname: Haldiman
authors.forename: R Cody
authors.initials: RC
authors.lastname: Weimholt
authors.forename: Gurmukh
authors.initials: G
authors.lastname: Singh
mesh_terms: D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality; D003362:Cost-Benefit Analysis; D006801:Humans; D007352:Insurance, Life / Q000706:statistics & numerical data*; D011379:Prognosis; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I