Ultra-sensitive troponin I is an independent predictor of incident coronary heart disease in the general population

Troponinsare sensitive markers of myocardial injury and predictive of cardiovascular events, but conventional assays fail to detect slightly elevated troponinsin a considerable proportion of the general population. Using a novel ultrasensitiveassay, we explored the relationship of troponinlevels with the incidence of coronary heart disease (CHD) in a case-cohort sample (mean age 52.5 ± 0.2 years, 51.5% women) comprising 803 CHD cases and 1942 non-cases. Ultrasensitive troponin Iwas detectable in 99.9% of available case-cohort samples. In an age- and sex-adjusted model, individuals in the highest quartileof the troponindistribution had a more than threefold increased risk for CHD events compared to those in the bottom quartile[ hazard ratio, HR, 3.11; 95% confidence interval (CI) 2.15–4.49]. In a model adjusting for cardiovascular risk factors including C-reactive protein, cystatin Cand N-terminal pro brain natriuretic peptide, individuals in the highest troponin I quartilestill showed a hazard ratioof 2.58 (95% CI 1.66–4.00) for incident CHD as compared to those in the lowest quartile. Ultrasensitive troponin Iwas detectable in almost all individuals of a study sample reflecting middle-aged to elderly European general population. Ultrasensitive troponinconcentrations exhibit an independent, graded, positive relation with incident CHD.