ArticleJournal of the American College of Cardiology2020
Atherosclerotic Cardiovascular Disease Risk Stratification Based on Measurements of Troponin and Coronary Artery Calcium.
Article in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Cardiac troponins and coronary artery calcium score: a systematic review.BMC cardiovascular disorders · 2024Pooled it
- Brazilian Guideline on Dyslipidemias and Prevention of Atherosclerosis - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Elevated concentrations of cardiac troponin T are associated with thoracic aortic calcification in non-dialysis chronic kidney disease patients of stage G3 to G5.Renal failure · 2025Article
- Interpretable and reproducible machine learning model for coronary calcification and segment-level stenoses stratification on computed tomography angiography.BMC medicine · 2025Article
- Challenges of using natriuretic peptides to screen for the risk of developing heart failure in patients with diabetes: a report from the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Committee on Clinical Applications of Cardiac Bio-Markers (C-CB).Clinical chemistry and laboratory medicine · 2025Article
- Associations of HLA-DRB1 shared epitope alleles with cardiovascular disease and events in a multi-ethnic community-living population: The multi-ethnic study of atherosclerosis (MESA).Human immunology · 2025Article
- Article
- Factors influencing Systemic Coronary Risk Estimation 2 (SCORE2).Cardiology journal · 2025Article
- Cardiovascular Aging and Risk Assessment: How Multimodality Imaging Can Help.Diagnostics (Basel, Switzerland) · 2024Review
- Opportunistic assessment of ischemic heart disease risk using abdominopelvic computed tomography and medical record data: a multimodal explainable artificial intelligence approach.Scientific reports · 2023Article
- Coronary Artery Disease Risk Prediction in Young Adults: How Can We Overcome the Dominant Effect of Age?Current atherosclerosis reports · 2023Review
- Computed tomography coronary angiography after excluding myocardial infarction: high-sensitivity troponin versus risk score-guided approach.World journal of emergency medicine · 2023Article
- Risk Factors for Incident Coronary Artery Calcium in Younger (Age 32 to 45 Years) Versus Intermediate (46 to 64 Years) Versus Older (65 to 84 Years) Persons.The American journal of cardiology · 2022Article
- Plasminogen Activator Inhibitor-1-Positive Platelet-Derived Extracellular Vesicles Predicts MACE and the Proinflammatory SMC Phenotype.JACC. Basic to translational science · 2022Article
- Article
- Approach to risk stratification of atherosclerotic cardiovascular disease: Use of biomarkers and imaging in a Canadian context.Canadian family physician Medecin de famille canadien · 2022Article
- Article
- New insights from the MESA study: increased high-sensitivity troponins as a cardiovascular risk factor.European heart journal supplements : journal of the European Society of Cardiology · 2021Article
- Acute Myocardial Injury and Rhabdomyolysis in COVID-19 Patients: Incidence and Mortality.Cureus · 2021Article
- Sex Differences in Cardiac Troponin I and T and the Prediction of Cardiovascular Events in the General Population.Clinical chemistry · 2021Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundLow values of high-sensitivity cardiac troponin (hs-cTn) and coronary artery calcium (CAC) scores of zero are associated with a low risk for atherosclerotic cardiovascular disease (ASCVD).
objectivesThe purpose of this study was to evaluate baseline hs-cTnT and CAC in relation to ASCVD.
methodsBaseline hs-cTnT (limit of detection [LoD] 3 ng/l) and CAC measurements were analyzed across participants age 45 to 84 years without clinical cardiovascular disease from the prospective MESA (Multi-Ethnic Study of Atherosclerosis) in relationship to incident ASCVD.
resultsAmong 6,749 participants, 1,002 ASCVD events occurred during a median follow-up of 15 years. Participants with detectable CAC (20.1 vs. 5.0 events per 1,000 person-years; adjusted hazard ratio [HR]: 2.35; 95% confidence interval [CI]: 2.0 to 2.76; p < 0.001) and detectable hs-cTnT (15.4 vs. 5.2 per 1,000 person-years; adjusted HR: 1.47; 95% CI: 1.21 to 1.77; p < 0.001) had higher rates of ASCVD than those with undetectable results. Individuals with undetectable hs-cTnT (32%) had similar risk for ASCVD as did those with a CAC of zero (50%) (5.2 vs. 5.0 per 1,000 person-years). Together, hs-cTnT and CAC (discordance 38%) resulted in the following ASCVD event rates: hs-cTnT < LoD/CAC = 0: 2.8 per 1,000 person-years (reference), hs-cTnT ≥ LoD/CAC = 0: 6.8 per 1,000 person-years (HR: 1.59; 95% CI: 1.17 to 2.16; p = 0.003), hs-cTnT < LoD/CAC > 0: 11.1 per 1,000 person-years (HR: 2.74; 95% CI: 1.96 to 3.83; p < 0.00001), and hs-cTnT ≥ LoD/CAC > 0: 22.6 per 1,000 person-years (HR: 3.50; 95% CI: 2.60 to 4.70; p < 0.00001).
conclusionsAn undetectable hs-cTnT identifies patients with a similar, low risk for ASCVD as those with a CAC score of zero. The increased risk among those with discordant results supports their conjoined use for risk prediction.
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Registered trials
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