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Clinical Significance of High-Sensitivity Cardiac Troponin I and Myoglobin in Patients with Suspected Coronary

Jin Wang1, Hong Li2

  • 1Cardiovascular Medicine Department III, Dingxi People's Hospital, No. 22 Anding Road, Anding District, Dingxi City, 743000, Gansu Province, China.

Journal of Cardiovascular Translational Research
|July 16, 2026
PubMed

Insights

Elevated high-sensitivity cardiac troponin I (hs-cTnI) is linked to worse coronary microvascular dysfunction (CMD) and increased risk of major adverse cardiovascular events (MACE) in patients with suspected CMD.

Area of Science:

  • Cardiology
  • Biomarkers
  • Vascular Medicine

Background:

  • Coronary microvascular dysfunction (CMD) is a significant cause of chest pain.
  • Accurate risk stratification in suspected CMD remains challenging.
  • The role of cardiac biomarkers like hs-cTnI and myoglobin in CMD needs further clarification.

Purpose of the Study:

  • To investigate the distribution and prognostic value of high-sensitivity cardiac troponin I (hs-cTnI) and myoglobin in patients with suspected CMD.
  • To assess the association of hs-cTnI and myoglobin levels with coronary flow reserve (CFR) and major adverse cardiovascular events (MACE).

Main Methods:

  • Prospective study of 1,524 patients with suspected CMD undergoing assessment of hs-cTnI, myoglobin, and CFR.
  • Patients categorized by hs-cTnI levels using the 99th percentile cutoff (28 ng/L).
  • Multivariable regression and survival analyses evaluated associations with impaired CFR and MACE.

Main Results:

  • Elevated hs-cTnI was observed in 27.0% of patients.
  • Higher hs-cTnI levels showed an inverse correlation with CFR.
  • Each 10 ng/L increase in hs-cTnI independently predicted impaired CFR (aOR 1.32) and higher MACE risk (aHR 2.35) over 24.5 months.
  • Myoglobin alone was not predictive, but its concurrent elevation with hs-cTnI amplified MACE risk.

Conclusions:

  • Elevated hs-cTnI is an independent predictor of worse microvascular function in suspected CMD.
  • hs-cTnI is a valuable biomarker for identifying patients at higher risk of adverse cardiovascular outcomes.
  • Combined assessment of hs-cTnI and myoglobin may refine risk stratification in CMD.

Keywords:
Coronary flow reserveCoronary microvascular dysfunctionHigh-sensitivity cardiac troponin IMajor adverse cardiovascular eventsMyoglobinPrognosis

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