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Prevalence and determinants of troponin T elevation in the general population

Thomas W Wallace1, Shuaib M Abdullah, Mark H Drazner

  • 1Donald W. Reynolds Cardiovascular Clinical Research Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-9047, USA.

Circulation
|April 19, 2006
PubMed

Insights

Cardiac troponin T (cTnT) elevation is rare in the general population, especially in those without heart failure, hypertrophy, diabetes, or kidney disease. Even minimal elevations may indicate subclinical cardiac injury.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Population Health

Background:

  • Prevalence and significance of cardiac troponin T (cTnT) elevation in the general population are largely unknown.
  • Minimally increased cTnT levels and their clinical implications remain controversial.
  • Lack of data on cTnT determinants in a representative population sample.

Purpose of the Study:

  • To determine the prevalence of cTnT elevation in the general population.
  • To identify clinical and demographic determinants of cTnT elevation.
  • To assess the significance of minimally increased cTnT levels.

Main Methods:

  • Analysis of stored plasma samples from 3557 subjects in the Dallas Heart Study.
  • Correlation of cTnT elevation with clinical variables and cardiac MRI findings.
  • Univariable and multivariable logistic regression analyses to identify independent predictors.

Main Results:

  • The prevalence of cTnT elevation (> or =0.01 microg/L) was 0.7% in the general population.
  • Elevated cTnT was associated with older age, black race, male sex, coronary artery calcium, congestive heart failure (CHF), left ventricular hypertrophy (LVH), diabetes mellitus (DM), and chronic kidney disease (CKD).
  • LVH, CHF, DM, and CKD were independently associated with cTnT elevation in multivariable analysis.

Conclusions:

  • cTnT elevation is rare in individuals without CHF, LVH, CKD, or DM.
  • The upper limit of normal for cTnT immunoassays may need to be <0.01 microg/L.
  • Minimally increased cTnT may signify subclinical cardiac injury, warranting further longitudinal outcome studies.
Abstract

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