ArticleJournal of the American Geriatrics Society2021
High-Sensitivity Cardiac Troponin I for Risk Stratification in Older Adults.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Association of high-sensitivity cardiac troponin T with all-cause and cardiovascular mortality in a mobile cohort of older adults aged 70 to 95 years - Results from the AugUR study.American journal of preventive cardiology · 2026Article
- Serial high-sensitivity cardiac troponin I trajectories predict cardiovascular events in hemodialysis patients.Clinical kidney journal · 2025Article
- Association of cardiorenal biomarkers with mortality in metabolic syndrome patients: A prospective cohort study from NHANES.Chronic diseases and translational medicine · 2024Article
- Association of left atrial function with frailty: The Atherosclerosis Risk in Communities (ARIC) study.Journal of the American Geriatrics Society · 2024Article
- Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy.Atherosclerosis plus · 2024Article
- Modeling the Impact of Biomarker-Guided Versus ASCVD Risk-Guided Drug Treatment in US Adults With Stage 1 Hypertension: The National Health and Nutrition Examination Survey, 1999 to 2004.Hypertension (Dallas, Tex. : 1979) · 2024Article
- Optimizing the Clinical Use of High-Sensitivity Troponin Assays: A Review.Diagnostics (Basel, Switzerland) · 2023Review
- Characterization of Myocardial Injury With High-Sensitivity Troponin.Texas Heart Institute journal · 2023Article
- Associations of Cardiac Biomarkers With Peripheral Artery Disease and Peripheral Neuropathy in US Adults Without Prevalent Cardiovascular Disease.Arteriosclerosis, thrombosis, and vascular biology · 2023Article
- Framingham and American College of Cardiology/American Heart Association Pooled Cohort Equations, High-Sensitivity Troponin T, and N-Terminal Pro-Brain-Type Natriuretic Peptide for Predicting Atherosclerotic Cardiovascular Events Across the Spectrum of Kidney Dysfunction.Journal of the American Heart Association · 2022Article
- Accounting for frailty and multimorbidity when interpreting high-sensitivity troponin I tests in oldest old.Journal of the American Geriatrics Society · 2022Article
- High sensitivity troponins: A potential biomarkers of cardiovascular risk for primary prevention.Frontiers in cardiovascular medicine · 2022Review
- Prevalence and Prognostic Value ofJournal of clinical medicine · 2021Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesTraditional cardiovascular risk factors are less predictive in older age. High-sensitivity cardiac troponin I (hs-cTnI) is a marker of subclinical cardiomyocyte damage associated with cardiovascular risk in middle-aged adults. We hypothesized hs-cTnI would be indicative of mortality and cardiovascular risk beyond traditional cardiovascular risk factors in older adults and may be more discriminatory compared to hs-troponin T (hs-cTnT).
designProspective cohort study.
settingPopulation-based Atherosclerosis Risk in Communities (ARIC) Study.
participantsWe included 5,876 ARIC participants at Visit 5 (2011-2013). OUTCOMES AND MEASURES: We used Cox regression for the association of hs-cTnI categories (women: <4, 4-<10, ≥10 ng/ml; men: <6, 6-<12, ≥12 ng/ml, prevalent cardiovascular disease (CVD)) with mortality and incident CVD (atherosclerotic CVD [ASCVD]: coronary heart disease or stroke, or heart failure).
resultsParticipants were ages 66 to 90, 23% black, 42% male, and 24% had prevalent CVD. There were 1,053 (321 CVD) deaths (median follow-up 6.3 years). Participants with elevated hs-cTnI and no CVD (7% of participants) had mortality risk similar to those with a history of CVD (55.6 vs 55.7 deaths/1,000 person-years, P = .99). After adjustment, elevated hs-cTnI and no CVD (hazard ratio (HR) = 2.38, 95% confidence interval (CI) = 1.85-3.06) and prevalent CVD (HR = 2.21, 95% CI = 1.90-2.57) remained associated with mortality, compared to low hs-cTnI and no CVD. Elevated hs-cTnI was independently associated with incident CVD (HR = 3.41, 95% CI = 2.58-4.51), ASCVD (HR = 2.02, 95% CI = 1.36-2.98), and heart failure (HR = 6.16, 95% CI = 4.24-8.95). The addition of hs-cTnI significantly improved C-statistics for all outcomes and added greater discrimination than hs-cTnT for cardiovascular mortality and incident heart failure.
conclusionsHs-cTnI improves mortality and CVD risk stratification in older adults beyond traditional risk factors and improved model discrimination more than hs-cTnT for certain outcomes. Elevated hs-cTnI without CVD identifies a high-risk group with comparable mortality risk as those with a history of clinical CVD.
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