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High-sensitive cardiac troponin I (hs-cTnI) values in patients with stable cardiovascular disease: an initial foray

Olaf Schulz1, Markus Reinicke, Gunnar H Berghoefer

  • 1Interventionelle Kardiologie Spandau, Berlin, Germany.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|March 2, 2010
PubMed

Insights

High-sensitivity troponin I (hs-cTnI) is detectable in stable cardiac patients. However, hs-cTnI did not reliably distinguish cardiac disease causes or predict prognosis in this group.

Area of Science:

  • Cardiology
  • Biomarkers
  • Cardiac Diagnostics

Background:

  • The clinical utility of novel high-sensitivity troponin assays in stable cardiac patients remains uncertain.
  • Preliminary studies suggest potential for risk stratification using these assays.
  • This study investigates the determinants, diagnostic impact, and prognostic value of a novel high-sensitive cardiac troponin I (hs-cTnI) assay.

Purpose of the Study:

  • To evaluate the determinants of hs-cTnI levels in stable cardiac patients.
  • To assess the diagnostic impact of hs-cTnI in differentiating cardiac disease etiologies.
  • To determine the prognostic value of hs-cTnI in predicting outcomes for stable cardiac disease.

Main Methods:

  • hs-cTnI was measured using a pre-commercial assay in 222 outpatients prior to cardiac catheterization.
  • Patients were followed for a mean of 1103 days.
  • Statistical analysis identified predictors of hs-cTnI concentration.

Main Results:

  • hs-cTnI was detectable in all patients, with median concentrations of 6.20 ng/l.
  • Creatinine, systolic wall stress, myocardial impairment, and coronary artery stenosis >70% predicted hs-cTnI levels.
  • hs-cTnI could not differentiate between myocardial and coronary abnormalities, and prognosis prediction was not robust.

Conclusions:

  • Detectable hs-cTnI concentrations are common in stable cardiovascular patients, regardless of underlying disease.
  • hs-cTnI values were not helpful in distinguishing the etiology of cardiac disease in this heterogeneous group.
  • The prognostic value of hs-cTnI for predicting outcomes in stable cardiac disease was limited.
Abstract

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