The silent warning: High-sensitivity cardiac troponin as a biomarker for subclinical coronary artery disease in seemingly healthy Japanese population

Objectives High-sensitivity cardiac troponin (cTn) assays are established for diagnosing acute myocardial infarction, but their distribution and clinical relevance in healthy Japanese populations remain unclear. This study clarified sex differences in high-sensitivity cTnI and cTnT levels and evaluated their associations with estimated 10-year coronary heart disease (CHD) risk in a healthy Japanese population. Methods We conducted the study at the Shizuoka Broadcasting Service Shizuoka Health Promotion Center between December 2012 and March 2013 and included 808 participants (541 males and 267 females) with no history of CHD. Estimated 10-year CHD risks were calculated using the Framingham and Suita risk scores. Multivariable linear regression analyses were performed using log-transformed cTn levels as dependent variables and cardiovascular risk factors as explanatory variables. We compared the estimated 10-year incidence of CHD across groups, divided by troponin quartile. Results Both cTnI and cTnT levels were significantly higher in males than in females. No significant multicollinearity was observed (all variance inflation factors <2.0). Group comparisons showed that the estimated 10-year CHD risk increased stepwise with higher cTn quartiles. Conclusions High-sensitivity cTnI and cTnT levels are independently associated with estimated 10-year CHD risk scores in a healthy Japanese population.