Cardiac troponin I levels independently predicted all-cause mortality (adjusted HR 1.44; 95% CI 1.18 to 1.77) and increased over time in elderly community dwellers.
Cohort (n=1,004)
Do high-sensitive cardiac troponin I levels predict mortality in elderly community dwellers?
High-sensitive cardiac troponin I levels are detectable in most elderly individuals, increase over time, and independently predict all-cause and cardiovascular mortality.
Hazard Ratio: 1.44 (95% CI 1.18–1.77)
OBJECTIVES: This study sought to assess changes in troponin levels, underlying conditions, and the prognostic implications in elderly subjects from the community. BACKGROUND: Cardiac troponin levels are often detectable in community dwellers when sensitive assays are applied. However, information on the course of troponin levels over time is limited. METHODS: Cardiac troponin I (cTnI) was measured by using a novel, high-sensitive assay in community dwellers aged 70 years from the Prospective Investigation of the Vasculature in Uppsala Seniors study. Measurements were performed at baseline (n = 1,004) and after 5 years (n = 814). Total follow-up was 8.0 years. RESULTS: cTnI levels were detectable in 968 (96.4%) subjects at baseline and independently predicted all-cause mortality (adjusted hazard ratio HR: 1.44 95% confidence interval (CI): 1.18 to 1.77) and cardiovascular mortality (adjusted HR: 1.66 95% CI: 1.20 to 2.29) when levels from baseline and 5-year follow-up were used as updated covariates. The integrated discrimination improvement of cTnI regarding all-cause mortality was 0.014 (p = 0.04), and the category-free net reclassification improvement was 0.231 (p = 0.02). Median cTnI levels increased by 45% between both measurements. The change in cTnI levels was significantly related to male sex (p = 0.02), body mass index (p = 0.01), high-density lipoprotein cholesterol (p = 0.005), N-terminal pro-B-type natriuretic peptide (p = 0.004), and left ventricular ejection fraction (p = 0.04), and it independently predicted all-cause mortality occurring after 5-year follow-up (adjusted HR: 1.97 95% CI: 1.14 to 3.40; p = 0.02). CONCLUSIONS: Using a novel high-sensitive assay, cTnI levels could be determined in nearly all elderly study subjects. cTnI levels increased over time and were a strong marker of mortality risk. Our data suggest that cTnI might offer utility for clinical assessment of subjects in the general population.
Eggers et al. (Wed,) conducted a cohort in Elderly community dwellers (n=1,004). Cardiac troponin I (cTnI) levels was evaluated on All-cause mortality (HR 1.44, 95% CI 1.18 to 1.77). Cardiac troponin I levels independently predicted all-cause mortality (adjusted HR 1.44; 95% CI 1.18 to 1.77) and increased over time in elderly community dwellers.