High-density lipoprotein cholesterol values independently and inversely predict cardiac troponin T and I
Giuseppe Lippi1, Claudia Lo Cascio1, Giorgio Brocco1
11 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy.
Insights
High-density lipoprotein cholesterol (HDL-C) levels inversely predict cardiac troponin concentrations, regardless of age or sex. This finding highlights HDL-C as a key factor in understanding cardiac troponin variability.
Area of Science:
- Cardiology
- Clinical Chemistry
- Biomarker Research
Background:
- Cardiac troponins are critical biomarkers for myocardial injury.
- Conventional blood lipids are established cardiovascular risk factors.
- The relationship between troponins and lipids requires further elucidation.
Purpose of the Study:
- To investigate potential associations between circulating cardiac troponin values and conventional blood lipid levels.
- To identify predictors of troponin concentration in a routine clinical setting.
Main Methods:
- Retrospective analysis of inpatient data from the University Hospital of Verona (2015).
- Measurement of serum lipids (TC, HDL-C, LDL-C, TG) and high-sensitivity troponin T (HS-TnT).
- Secondary analysis of troponin I (TnI) and lipid data from the General Hospital of Verona.
Main Results:
- High-sensitivity troponin T (HS-TnT) showed univariate associations with age, sex, TC, LDL-C, and HDL-C.
- Multivariate analysis revealed age (positive) and HDL-C (negative) as significant predictors of HS-TnT.
- Higher HS-TnT levels were observed in subjects with lower HDL-C and in older individuals.
- HDL-C was also a negative predictor of troponin I (TnI).
Conclusions:
- High-density lipoprotein cholesterol (HDL-C) inversely predicts cardiac troponin concentrations.
- Age and HDL-C levels together explain a significant portion of troponin variability.
- These findings suggest HDL-C is an important factor in cardiac troponin assessment.
Background:
This retrospective study was planned to establish potential associations between circulating values of cardiac troponins and those of conventional blood lipids.
Methods:
The study population consisted of patients attending an inpatient clinic of the University Hospital of Verona during the year 2015 as part of routine cardiovascular risk assessment. No exclusion criteria were applied. Serum lipids including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were measured using reference enzymatic techniques, whereas troponin T (TnT) was measured using a high-sensitivity (HS) immunoassay. A second analysis was also performed in the General Hospital of Verona, extracting data from the local laboratory database of all patients in whom troponin I (TnI) and blood lipids were simultaneously measured during the same year.
Results:
In univariate analysis, HS-TnT was found to be associated with age, sex, TC, LDL-C, HDL-C, but not with TG. In multivariate linear regression analysis, age (positive correlation; P<0.001) and HDL-C (negative correlation; P=0.032) remained significantly associated with HS-TnT. The frequency of HS-TnT values >50 ng/L was higher in subjects with HDL-C <1 mmol/L than in those with HDL-C ≥1 mmol/L [odds ratio (OR), 1.84; 95% confidence interval (CI), 1.03-3.32]. The frequency of HS-TnT values >50 ng/L was also higher in elderly subjects than in younger ones (OR, 2.10; 95% CI, 1.15-3.84). The combination of age and HDL-C explained 35% of overall variability of TnT concentration. In the second analysis, HDL-C was also found to be an independent and negative predictor of TnI in multivariate linear regression analysis (P=0.010). The combination of age and HDL-C explained approximately 28% of the overall variability of TnI concentration.
Conclusions:
Our study suggests that HDL-C values inversely predict cardiac troponins concentration irrespective of age, sex and other blood lipids.
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