Role of High-Sensitivity Troponins in Cardiovascular Risk Assessment in Asymptomatic Adults: A Systematic Review...

The causal relationship between high-sensitivity troponins (hs-cTn) and cardiovascular risk in asymptomatic adults remains incompletely established. [cite: 11] The objective of this systematic review is to evaluate the prognostic value of hs-cTn (hs-cTnI and hs-cTnT) in the general population free of clinical cardiovascular disease, and their potential to enhance the prediction of future cardiovascular risk when incorporated into conventional cardiovascular risk stratification models. [cite: 12] Methods: The literature search was conducted in the following electronic databases: PubMed, Google Scholar, ScienceDirect, and SpringerLink, to identify prospective cohort studies published between January 1, 2016, and February 28, 2024, examining the relationship between hs-cTn and cardiovascular risk in asymptomatic adult populations. [cite: 13] The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). [cite: 14] Results: The 19 studies included in this review involved a total of 250,513 participants. [cite: 15] The results confirm a significant association between hs-cTn levels and cardiovascular events. [cite: 16] The addition of these biomarkers to traditional risk prediction models often enhances their predictive performance, as evidenced by increases in the C-index (Concordance index), Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI). [cite: 17] hs-cTnI and hs-cTnT were moderately or weakly correlated but complementary, as they were associated with different types of cardiovascular events. [cite: 18] Conclusion: The inclusion of hs-cTn in predictive scores slightly improves their predictive accuracy. [cite: 19] Nevertheless, it remains necessary to demonstrate their clinical benefit through randomized trials before incorporating them into routine practice. [cite: 20].