Dynamic Changes in High-Sensitivity Cardiac Troponin I Levels Associate With Variations in Cardiovascular Risk Scores
Tiziana Bachetti1, Monica Lorenzoni1, Roberto Maestri2
1Scientific Directorate Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Pavia Pavia Italy.
Insights
Detectable high-sensitivity cardiac troponin I (hs-cTnI) in primary prevention patients indicates a poorer cardiovascular risk profile. Further research is needed to confirm its role in tracking long-term cardiovascular risk changes.
Area of Science:
- Cardiology
- Biomarkers
- Preventive Medicine
Background:
- Elevated high-sensitivity cardiac troponin I (hs-cTnI) is linked to adverse cardiovascular outcomes in the general population.
- The association between hs-cTnI levels within the normal range and cardiovascular risk score variations is not well understood.
Purpose of the Study:
- To investigate the relationship between detectable hs-cTnI and cardiovascular risk profiles in a primary prevention cohort.
- To explore whether changes in hs-cTnI levels over time correlate with changes in cardiovascular risk scores.
Main Methods:
- An observational substudy of the CV-PREVITAL project involving 810 primary prevention subjects.
- Hs-cTnI measured at baseline and 12 months, with cardiovascular risk assessed using validated scores.
- Diet adherence, sleep quality, and clinical parameters were recorded, alongside structured lifestyle counseling.
Main Results:
- Detectable hs-cTnI at baseline was associated with older age, higher BMI, larger waist circumference, higher blood pressure, lower HDL cholesterol, and higher glycated hemoglobin.
- Participants with detectable hs-cTnI had higher scores on Progetto Cuore, Framingham Risk Score, ASCVD, and Finnish Diabetes Risk scores.
- At 12 months, the proportion of participants with undetectable hs-cTnI increased significantly, and while risk scores generally improved, changes in hs-cTnI did not consistently correlate with these changes.
Conclusions:
- The presence of detectable hs-cTnI in a primary prevention cohort is linked to a less favorable cardiovascular risk profile.
- The utility of hs-cTnI for longitudinal monitoring of cardiovascular risk requires further validation against actual cardiovascular outcomes.
Background:
In the general population, elevated hs-cTnI (high-sensitivity cardiac troponin I) levels are linked to adverse cardiovascular outcomes. Whether changes in hs-cTnI within the normal range are associated with variations in cardiovascular risk scores remains unclear.
Methods:
This observational substudy of the CV-PREVITAL (Strategies for Primary Cardiovascular Prevention in the Italian Population) project evaluated 810 subjects (522 women) in primary prevention. Hs-cTnI was measured at baseline and after 12 months in 473 participants. Cardiovascular risk was assessed using validated scores along with diet adherence and sleep quality. Clinical and laboratory parameters were recorded. Participants received structured lifestyle counseling.
Results:
At baseline, hs-cTnI was undetectable in 59% of participants. Detectable hs-cTnI was associated with older age (58 versus 55 years), higher body mass index (26 versus 24 kg/m2), greater waist circumference (91 versus 85 cm), higher blood pressure (129 versus 123 mm Hg), lower high-density lipoprotein cholesterol (56 versus 59 mg/dL), higher glycated hemoglobin (40 versus 38 mmol/mol), all P<0.01. Progetto Cuore, Framingham Risk Score, Atherosclerotic Cardiovascular Disease, and Finnish Diabetes Risk scores were higher (all P<0.0001) in participants with detectable hs-cTnI, whereas the Moli-sani risk score did not differ. At 12 months, participants with undetectable hs-cTnI increased to 79% (P<0.0001). Although all scores but 1 improved at follow-up, changes in hs-cTnI were not consistently associated with changes in risk scores or therapy modifications in exploratory analyses.
Conclusions:
In this primary-prevention cohort, the presence of detectable hs-cTnI was associated with a less favorable risk profile. However, its usefulness in the longitudinal monitoring of cardiovascular risk changes requires validation against cardiovascular outcomes.
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