Key result
Predefined hs-TnI categories show poor concordance with Framingham risk scores in healthy blood donors.
Why the study?
Interpreting low-grade high-sensitivity cardiac troponin I concentrations reflecting myocardial injury in asymptomatic populations remains clinically uncertain.
Does high-sensitivity cardiac troponin I categorization agree with conventional cardiovascular risk assessment methods in apparently healthy blood donors?
Cross-Sectional (n=292)
No
Does high-sensitivity cardiac troponin I categorization agree with conventional cardiovascular risk assessment methods in apparently healthy blood donors?
Hs-TnI identifies a distinct biomarker phenotype of low-grade myocardial injury in asymptomatic individuals that is not captured by traditional risk scores.
Answers are grounded in this paper and cite their sources.
hs-TnI may flag distinct low-grade injury missed by conventional scores in healthy adults; leaves open its prognostic utility.
Background: Interpreting low-grade of high-sensitivity cardiac troponin I (hs-TnI) concentrations reflecting myocardial injury in asymptomatic populations remains clinically uncertain. This study characterized predefined sex-specific hs-TnI categories in apparently healthy blood donors and compared them with conventional cardiovascular assessment methods. Methods: We performed a cross-sectional analysis of 292 blood donors (77 women, 26.4%; 215 men, 73.6%; age range, 40–65 years). Hs-TnI was measured using the Abbott ARCHITECT STAT High Sensitive Troponin-I assay and categorized according to predefined sex-specific thresholds. Categories were compared with clinical variables, cholesterol/HDL-ratio categories, Framingham Risk Score categories, and SCORE2 in eligible participants (n = 287). Additional analyses included non-parametric comparisons, Spearman correlations, agreement statistics, and multivariable models. A sensitivity analysis used sex-specific empirical hs-TnI tertiles, and effect sizes with bootstrap 95% confidence intervals were reported for key comparisons. Results: Hs-TnI categories were low in 253 subjects (86.6%), intermediate in 17 (5.8%), and elevated in 22 (7.5%). Hs-TnI was markedly skewed, especially in the elevated category (median, 21.5 ng/L; IQR, 15.25–36.0; range, 11–199). Agreement with conventional categories was low, with weighted kappa values of 0.035 versus Framingham, −0.008 versus cholesterol/HDL-ratio categories, and 0.076 versus SCORE2. Conventional cardiovascular variables showed limited independent association with intermediate/elevated hs-TnI categories. Tertile-based sensitivity analyses yielded weighted kappa values of 0.045 versus Framingham, 0.033 versus cholesterol/HDL-ratio categories, and 0.037 versus SCORE2. Conclusions: In selected blood donors, predefined hs-TnI categories showed limited concordance with conventional cardiovascular scores, exploratory-wise suggesting a distinct phenotype of low-grade myocardial injury.
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Pignalosa et al. (2026) conducted a cross-sectional in Apparently healthy blood donors (n=292). High-sensitivity cardiac troponin I (hs-TnI) categories vs. Conventional cardiovascular risk assessment methods (Framingham, cholesterol/HDL-ratio, SCORE2) was evaluated on Agreement between predefined sex-specific hs-TnI categories and conventional cardiovascular assessment methods (Weighted kappa 0.035 vs Framingham). In apparently healthy blood donors, predefined hs-TnI categories showed limited concordance with conventional cardiovascular scores (weighted kappa 0.035 vs Framingham), suggesting a distinct phenotype of low-grade myocardial injury.
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