title: Determinants of minimal elevation in high-sensitivity cardiac troponin T in the general population.
abstract: OBJECTIVE
  To study the relationship between cardiovascular risk factors and detectable cardiac troponin-T using a highly sensitive assay (hs-cTnT) among persons without a history of cardiovascular disease.
  
  
  METHODS
  We examined the cross-sectional associations between cardiovascular risk factors and hs-cTnT in 9593 participants (mean age 65.6 (SD, 5.6), 41% female, 22% black) free of cardiovascular disease in a community-based cohort, through the Atherosclerosis Risk in Communities (ARIC) Study. We used multivariable logistic regression to characterize the association between cardiovascular risk factors and detectable (≥3.0 to 13.9ng/L) and elevated (≥14.0ng/L) hs-cTnT.
  
  
  RESULTS
  hs-cTnT was detectable in 59% and elevated in 7% of the study population. Among persons with ideal cardiovascular health, hs-cTnT was detectable in 44%. In models adjusting for significant determinants of hs-cTnT concentration, detectable hs-cTnT was more frequent among males, blacks and persons with diabetes and hypertension and less frequent among statin users, current smokers and drinkers. Other risk factors associated with detectable hs-cTnT were older age, lower kidney function and higher body mass index. These risk factors were associated with elevated hs-cTnT in a similar pattern.
  
  
  CONCLUSIONS
  In a community-based sample without cardiovascular disease hs-cTnT is detectable in most adults, even among those with ideal cardiovascular health. Although most traditional cardiovascular risk factors were significant determinants of detectable and elevated hs-cTnT, the associations were particularly robust for sex, age, race, hypertension and diabetes.
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, NY, USA; Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rubin
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Mariana
authors.initials: M
authors.lastname: Lazo
authors.affiliation: Department of Medicine, Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Department of Medicine, Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX, USA; Michael E DeBakey Veterans Affairs Hospital, Houston, TX, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.affiliation: Department of Medicine, Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Hoogeveen
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.affiliation: Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, USA.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: eselvin@jhu.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: Cardiovascular disease; Epidemiology; Risk factors; Troponin