Relationship Between High-Sensitivity Cardiac Troponin I and Blood Pressure Among Young and Healthy Adults

Aeschbacher, Stefanie; Schoen, Tobias; Bossard, Matthias; Lely, Stéphanie van der; Glättli, Kathrin; Todd, John; Estis, Joel; Risch, Martin; Müeller, Christian; Risch, Lorenz; Conen, David

doi:10.1093/ajh/hpu226

Cited by 39 publications

(32 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Supporting prior investigations,8 9 15 22 23 this biomarker substudy of ADVANCE demonstrates that circulating levels of cardiac troponin I can be detected using a high-sensitivity assay in free-living populations without prior clinical CVD. Remarkably, in our sample of older controls subjects, 100% had a measurable level of hs-cTnI.…”

Section: Discussionsupporting

confidence: 61%

“…However, there are limitations to keep in mind: First, the possibility of residual confounding by factors potentially associated with elevated troponin and not controlled for in the analysis, for example left ventricular hypertrophy,22 or other markers of left ventricular strain remains. Second, we could not rule out other causes of myocardial necrosis, such as myocarditis, although this is rare.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults

Iribarren

Chandra

Rana

et al. 2016

Heart

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults

Iribarren

Chandra

Rana

et al. 2016

Heart

View full text Add to dashboard Cite

“…These results are consistent with those we reported with hsTnT in the ROMICAT I biomarker sub-study (4). Beyond the obvious link to acute MI, predictors of circulating hsTn concentrations include a wide range of variables including the presence of hemodynamic, myocardial, and metabolic abnormalities (17–19); perhaps most prominently however has been the link between hsTn values with presence, severity, and biological instability of underlying coronary atherosclerosis (4,20). This suggests a potential role for hsTn to provide quantification of atherothrombotic risk, particularly in those without prevalent ACS.…”

Section: Discussionmentioning

confidence: 99%

Sensitive troponin assays in patients with suspected acute coronary syndrome: Results from the multicenter rule out myocardial infarction using computer assisted tomography II trial

Januzzi

Sharma

Zakroysky

et al. 2015

American Heart Journal

View full text Add to dashboard Cite

Background Sensitive troponin assays have been developed for the evaluation of patients with suspected acute coronary syndrome (ACS). We sought to compare the performance of a commercially available sensitive troponin I (sTnI) and pre-commercial highly sensitive (hs) TnI method to conventional (c)Tn assays. Methods Among patients with acute chest pain but normal cTn in the emergency department of 6 centers, sTnI and hsTnI were measured at baseline, two and four hours following presentation. Diagnostic accuracy of sTnI and hsTnI relative to cTn for diagnosis during index hospitalization, as well as their associations with CAD in patients randomized to coronary computed tomographic angiography (CTA) were assessed. Results Overall, 322 patients were enrolled, of whom 161 had a CTA; 28 had ACS (8.7%), including 21 with UAP. Both sTnI and hsTnI values at baseline and second draw had significantly higher sensitivity for ACS and UAP than cTn, and had significantly greater area under the receiver operator characteristic curve than cTn at first and second draws. Compared to cTn, 29% of ACS cases previously categorized as UAP were reclassified to acute MI with sTnI or hsTnI. An hsTnI below limit of detection had 100% negative predictive value for ACS or significant coronary artery stenosis in those randomized to CCTA. Conclusions In patients with acute chest discomfort, use of sTnI and hsTnI methods led to significant improvement in the early diagnostic accuracy for ACS, reclassifying one third of UAP to MI. Very low values for hsTnI excluded underlying CAD.

show abstract

“…Even if hypertension is more prevalent in the non‐ACS group with cTnT levels ≥ 14 ng/l, it is not predictive for cTnT elevation in the multivariate analysis in our study's population. For both cardiac Troponin I and Troponin T association with systolic blood pressure is known . However, hypertensive blood pressures not always seem to be sufficient for elevated cTn levels.…”

Section: Discussionmentioning

confidence: 99%

“…were not predictive to describe the underlying mechanism of troponin elevation in terms of ACS and non-ACS, respectively. 2 19,20 However, hypertensive blood pressures not always seem to be sufficient for elevated cTn levels. In a substudy of rate control in atrial fibrillation (RATAF), there was no association to cTnT and hypertension.…”

Section: Discussionmentioning

confidence: 99%

Non‐coronary predictors of elevated high‐sensitive cardiac troponin T (hs‐cTnT) levels in an unselected emergency patient cohort

Berger

Emir

Brünnler

et al. 2018

Clinical Cardiology

View full text Add to dashboard Cite

Background Aim of this study was to evaluate the predictors of hs‐cTnT in a non‐ACS patient cohort admitted to the emergency department. Hypothesis Atrial fibrillation and hypertension may not always be sufficient for elevation for hs‐cTnT. Methods We performed a retrospective, single center study encompassing in total 1003 patients. Individuals were retrospectively divided in ACS‐ and non‐ACS patients by two independent investigators reviewing the medical records. In order to identify predictors of hs‐cTnT elevation hazard ratios were calculated for age, gender, vital signs, cardiovascular risk factors, LVEF, serum levels of CRP, hemoglobin, and creatinine. Elevation of hs‐cTnT was defined by exceeding 14 ng/L (upper reference limit [URL]). Results About 987 patients were included while 25 patients were excluded because of missing data. 307 patients (31.4%) met the current guideline requirements of diagnosing an ACS, whereas 671 patients (68.6%) were hospitalized with excluded ACS. In the multivariate analysis age, anemia, CRP, creatinine, and reduced systolic left ventricular ejection fraction were independent predictors of elevated troponin T levels in the non‐ACS group. However, hypertensive systolic blood pressure, atrial fibrillation and tachycardia were not predictive for Troponin T elevation in non‐ACS patients in this multivariate analysis. Conclusions In an unselected, non‐ACS patient cohort age, chronic renal failure, inflammatory state, and reduced left ventricular systolic function were associated with hs‐cTnT levels above the upper reference limit. Rather, often supposed predictors as atrial fibrillation, hypertension, and tachycardia cannot sufficiently explain increased hs‐cTnT in our study. Hence, further studies are needed to assess whether isolated hypertension, tachycardia, or atrial fibrillation sufficiently explain elevated hs‐cTnT.

show abstract

Relationship Between High-Sensitivity Cardiac Troponin I and Blood Pressure Among Young and Healthy Adults

Abstract: Using a hs assay, hs-cTnI was detectable in virtually all participants of a young and healthy population. hs-cTnI was independently associated with systolic BP and left ventricular hypertrophy.

Cited by 39 publications

References 38 publications

High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults

High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults

Sensitive troponin assays in patients with suspected acute coronary syndrome: Results from the multicenter rule out myocardial infarction using computer assisted tomography II trial

Non‐coronary predictors of elevated high‐sensitive cardiac troponin T (hs‐cTnT) levels in an unselected emergency patient cohort

Contact Info

Product

Resources

About