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High-Sensitivity Cardiac Troponin I in Apparently Healthy Blood Donors: Cross-Sectional Distribution and Discordance

Stefano Pignalosa1, Valeria Carnazzo1, Sara Tartaglione1

  • 1Department of Clinical Pathology, Santa Maria Goretti Hospital, 04100 Latina, Italy.

Diagnostics (Basel, Switzerland)
|July 28, 2026
PubMed

Insights

Interpreting low-grade cardiac troponin I (hs-TnI) in healthy individuals is unclear. This study found predefined hs-TnI categories poorly matched conventional cardiovascular risk scores in blood donors.

Area of Science:

  • Cardiology
  • Biomarkers
  • Preventive Medicine

Background:

  • Interpreting low-grade myocardial injury using high-sensitivity cardiac troponin I (hs-TnI) in asymptomatic individuals presents clinical challenges.
  • This study aimed to characterize predefined sex-specific hs-TnI categories in healthy blood donors.
  • Comparison with established cardiovascular assessment methods was performed to evaluate hs-TnI's utility.

Purpose of the Study:

  • To characterize predefined sex-specific high-sensitivity cardiac troponin I (hs-TnI) categories in apparently healthy blood donors.
  • To compare these hs-TnI categories with conventional cardiovascular risk assessment tools.
  • To investigate the association between hs-TnI levels and traditional cardiovascular risk factors.

Main Methods:

  • Cross-sectional analysis of 292 blood donors (40-65 years) using the Abbott ARCHITECT STAT High Sensitive Troponin-I assay.
  • Hs-TnI categorization based on predefined sex-specific thresholds.
  • Comparison of hs-TnI categories with Framingham Risk Score, cholesterol/HDL-ratio, and SCORE2 using agreement statistics and multivariable models.

Main Results:

  • Most donors (86.6%) had low hs-TnI; 5.8% intermediate, 7.5% elevated.
  • Hs-TnI distribution was skewed, particularly in the elevated category (median 21.5 ng/L).
  • Agreement between hs-TnI categories and conventional scores (Framingham, cholesterol/HDL-ratio, SCORE2) was low (weighted kappa values < 0.08).

Conclusions:

  • Predefined hs-TnI categories demonstrated limited concordance with conventional cardiovascular risk scores in this blood donor cohort.
  • Conventional cardiovascular variables showed minimal independent association with intermediate or elevated hs-TnI categories.
  • Findings suggest hs-TnI may represent a distinct phenotype of low-grade myocardial injury, warranting further investigation.

Keywords:
Framingham Risk ScoreSCORE2biomarker categorizationblood donorscardiovascular risk assessmentcross-sectional studyhigh-sensitivity cardiac troponin I

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