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European Heart Journal Advance Access published online on July 7, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn327
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Prevalence and pathophysiological mechanisms of elevated cardiac troponin I levels in a population-based sample of elderly subjects

Kai M. Eggers1,*, Lars Lind2, Håkan Ahlström3, Tomas Bjerner3, Charlotte Ebeling Barbier3, Anders Larsson4, Per Venge4 and Bertil Lindahl1

1 Department of Medical Sciences, Cardiology, Uppsala University Hospital, S-751 85 Uppsala, Sweden
2 Department of Medicine, Uppsala University Hospital, S-751 85 Uppsala, Sweden
3 Department of Radiology, Uppsala University Hospital, S-751 85 Uppsala, Sweden
4 Department of Clinical Chemistry, Uppsala University Hospital, S-751 85 Uppsala, Sweden

Received 5 December 2007; revised 17 June 2008; accepted 19 June 2008.

* Corresponding author. Tel: +46 18 611 00 00, Fax: +46 18 50 66 38, Email kai.eggers{at}ucr.uu.se

Aims: To evaluate the prevalence of cardiac troponin I (cTnI) elevation in an elderly community population and the association of cTnI levels with cardiovascular risk factors, vascular inflammation, atherosclerosis, cardiac performance, and areas indicative of infarcted myocardium identified by cardiac magnetic resonance imaging.

Methods and results: cTnI elevation defined as cTnI levels >0.01 µg/L (Access AccuTnI, Beckman Coulter) was found in 21.8% of the study participants (n = 1005). cTnI > 0.01 µg/L was associated with cardiovascular high-risk features, the burden of atherosclerosis in the carotid arteries, left-ventricular mass, and impaired left-ventricular systolic function. No associations were found between cTnI and inflammatory activity, diastolic dysfunction, or myocardial scars. Male gender (OR 1.6; 95% CI 1.1–2.4), ischaemic ECG changes (OR 1.7; 95% CI 1.1–2.7), and NT-pro-brain natriuretic peptide levels (OR 1.4; 95% CI 1.1–1.7) independently predicted cTnI > 0.01 µg/L. cTnI > 0.01 µg/L correlated also to an increased cardiovascular risk according to the Framingham risk score.

Conclusion: cTnI > 0.01 µg/L is relatively common in elderly subjects and is associated with cardiovascular high-risk features and impaired cardiac performance. Cardiac troponin determined by a highly sensitive assay might thus serve as an instrument for the identification of subjects at high cardiovascular risk in general populations.

Key Words: Cardiac troponin • Cardiovascular disease • Risk prediction


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