Prognostic Value of High-sensitivity Troponin I for Cardiovascular Events in the Population of Kyrgyzstan
Anna Belinova1, Cevahir Alioglu2, Myskal Duishenalieva3
1Therapy Department 2, Medical Faculty, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyzstan.
Insights
High-sensitivity cardiac troponin I (hs-cTnI) predicts cardiovascular events in Kyrgyzstan's general population. Lower risk thresholds in this Central Asian cohort suggest unique ethnic considerations for cardiovascular prevention strategies.
Area of Science:
- Cardiology
- Biomarkers
- Epidemiology
Background:
- High-sensitivity cardiac troponin I (hs-cTnI) is a key biomarker for myocardial injury and cardiovascular event prediction.
- Limited data exist on hs-cTnI prognostic value in Central Asia, specifically the Kyrgyz Republic.
Purpose of the Study:
- To assess the prognostic significance of hs-cTnI for cardiovascular events in the general population of the Chuy region, Kyrgyz Republic.
- To investigate potential sex and ethnic differences in hs-cTnI associations with cardiovascular risk.
Main Methods:
- A population-based study of 1275 individuals (age 20-64) from the Chuy region.
- Serum hs-cTnI measured via chemiluminescent immunoassay; 7-year follow-up for cardiovascular events.
- Cox proportional hazards regression adjusted for cardiovascular risk factors.
Main Results:
- 179 cardiovascular events (16.7%) occurred during follow-up.
- Elevated hs-cTnI independently predicted adverse outcomes (HR 1.23; 95% CI 1.05-1.42).
- Risk thresholds varied by sex and ethnicity (e.g., ≥2.3 ng/L for men, ≥0.4 ng/L for women).
Conclusions:
- Elevated hs-cTnI is an independent predictor of cardiovascular morbidity and mortality in the Kyrgyz Republic's general population.
- Observed lower risk thresholds compared to European cohorts may indicate ethnic differences.
- Region-specific approaches are crucial for cardiovascular risk assessment and prevention strategies.
Introduction:
High-sensitivity cardiac troponin I (hs-cTnI) is a precise biomarker of myocardial injury and a potential predictor of future cardiovascular events. However, data on its prognostic value in the general population of Central Asia, including the Kyrgyz Republic, are scarce. Therefore, this study aimed to evaluate the prognostic significance of hs-cTnI for cardiovascular events in the general population of the Chuy region, Kyrgyz Republic.
Methods:
This study was conducted as part of the "Interepid" project on a representative sample (n = 1275; age range 20-64 years). Serum hs-cTnI concentrations were measured using a chemiluminescent immunoassay (Abbott Architect i2000SR). Participants were followed for seven years. The primary endpoint included both fatal and nonfatal cardiovascular events. Data were analyzed using Cox proportional hazards regression models adjusted for traditional cardiovascular risk factors.
Results:
During the follow-up period, 179 cardiovascular events occurred (16.7%). Elevated hscTnI levels were independently associated with a higher risk of adverse outcomes (hazard ratio [HR] 1.23; 95% confidence interval [CI] 1.05-1.42). The strongest associations were observed among Kyrgyz women and Slavic men, whereas weaker associations were found in Kyrgyz men. The hs-cTnI thresholds associated with increased risk were ≥2.3 ng/L for men and ≥0.4 ng/L for women.
Discussion:
In this first population-based study from the Kyrgyz Republic, elevated hs-cTnI concentrations were independently associated with cardiovascular morbidity and mortality across sex and ethnic subgroups. The observed association likely reflects subclinical myocardial injury influenced by multiple factors rather than a direct causal relationship. Lower hs-cTnI thresholds associated with risk compared with European cohorts may indicate ethnic differences, highlighting the importance of region-specific approaches to cardiovascular risk assessment.
Conclusion:
High-sensitivity cardiac troponin I is an independent predictor of cardiovascular events in the general population of the Chuy region. The elevated risk observed at lower hs-cTnI levels compared with European populations should be considered in the development of national cardiovascular prevention strategies.
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