title: Troponin T release is associated with silent myocardial ischaemia in black men: The SABPA Study.
abstract: Background High sensitivity cardiac troponin T (hs-cTnT) is a validated marker of myocardial damage and may reflect the degree of silent myocardial ischaemia (SMI) and ventricular strain. Our aim was to compare hs-cTnT levels in black and white South Africans taking SMI into consideration. We further explored the capability of hs-cTnT to predict the presence of compensatory systolic hypertension in this South African cohort. Methods A bi-ethnic sex cohort ( n = 404) with similar socioeconomic status (198 black participants and 206 white participants, aged 20-65 years) participated in this target population study where 24 h ambulatory blood pressure, electrocardiogram and overnight fasting cardiometabolic variables were measured. Results Hypertension, higher glycated haemoglobin levels and more frequent and longer SMI events were observed more often in the black participants. Multivariate linear regression analysis showed positive associations between SMI events [Adj. R2= 0.19; β 0.35 (0.08-0.62); p < 0.01], SMI event maximum duration [Adj. R2= 0.17, β 0.43 (0.16-0.70), p < 0.01], SMI total duration [Adj. R2= 0.12; β 0.37 (0.10; 0.65), p = 0.05] and hs-cTnT in black males only.] A lower hs-cTnT cut-point ≥4.2 pg/ml for 24 h systolic hypertension was predicted in the black participants compared with ≥5.6 pg/ml in the white participants (area under the curve 0.66-67 (95% CI: 0.57-0.75), p < 0.001) with a respective sensitivity/specificity of 64/68% and 61/71%. Conclusions hs-cTnT may be a potential marker of SMI in the prediction of systolic blood pressure increases, as well as clusters of risk factors for cardiovascular disease. Ethnic- and possibly sex-specific references values for hs-cTnT should be considered for risk stratification.
authors.affiliation: 1 Hypertension in Africa Research Team, North-West University, South Africa.
authors.forename: Madelein E
authors.initials: ME
authors.lastname: Griffiths
authors.affiliation: 1 Hypertension in Africa Research Team, North-West University, South Africa.
authors.forename: Leoné
authors.initials: L
authors.lastname: Malan
authors.affiliation: 2 Department of Chemical Pathology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.
authors.forename: Rhena
authors.initials: R
authors.lastname: Delport
authors.affiliation: 3 Medicine Usage in South Africa, North-West University, South Africa.
authors.forename: Marike
authors.initials: M
authors.lastname: Cockeran
authors.affiliation: 4 Autonomic and Neuroendocrinological Laboratory Dresden, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
authors.forename: Manja
authors.initials: M
authors.lastname: Reimann
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D044383:Black People; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013019:South Africa / Q000453:epidemiology; D020107:Troponin T / Q000097:blood*; D044465:White People; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: ethnicity; hs-cTnT; hypertension; sex; silent myocardial ischaemia