High-sensitivity troponin I Linked with Adverse CV Outcomes

Elevated concentrations of high-sensitivity troponin I (hsTnI) were associated with several adverse cardiovascular outcomes, new study results suggest.

“Evaluation of stable symptomatic outpatients with suspected coronary artery disease (CAD) may be challenging because they have a wide range of cardiovascular risk,” the authors wrote in their abstract. “The role of troponin testing to assist clinical decision making in this setting is unexplored.”

The researchers looked at blood samples from 4,021 participants with stable chest symptoms and suspected CAD for the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE). Participant hsTnI was analyzed relative to the study endpoints death, acute myocardial infarction (MI), or hospitalization for unstable angina by 1 year.

The authors reported that 98.6% of participants had measurable hsTnI concentrations. The analysis results indicated that higher hsTnI was associated with greater event probabilities for the study endpoints (death, acute MI, or hospitalization for unstable angina). Multivariable models showed that hsTnI concentrations were independently associated with the study endpoints (P<0.001), and that they were associated with near-term events compared to longer follow-up.

The study was published in the Journal of the American College of Cardiology.

Do you check hsTroponin in your stable outpatients with chest pain? New #JACC analysis examines this strategy: https://t.co/MSXatvgrM3. @JJheart_doc #cardiotwitter pic.twitter.com/Z9owfyx9ZQ

— JACC Journals (@JACCJournals) January 24, 2019

Can hs-troponin measurement in patients with stable chest pain help in risk stratification and diagnosis?

– wonderful analysis from PROMISE in @JACCJournals by @JJheart_doc et al. #Cardiology #Cardiotwitter #troponin #atherosclerosis https://t.co/RRp8rrocqZ pic.twitter.com/H9NSxhgfjl

— Konstantin Krychtiuk (@krychtiukmd) January 30, 2019

https://twitter.com/marcreixell/statuses/1088639067560960000

No surprise: hsTroponins are a marker of outcome in pts with stable #CAD https://t.co/Sr9xyXMnnp

— Niti R. Aggarwal, MD, FSCMR, FASNC, FACC (@NitiCardio) January 23, 2019

We are all "troponin positive"(a term of reference that needs to go away). Magnitude(of elevation), clinical context, atherosclerotic burden matters.
Single-Molecule hsTnI and Short-Term Risk in Stable Patients With Chest Pain https://t.co/aiaGk1cE1D

— xavier prida (@XavierPrida) January 27, 2019

Analysis of high-sensitivity troponin in PROMISE trial, low levels of hsTn in patients with stable chest pain predict future MACE. https://t.co/dxWBaYFRo7 Great work lead by @JJheart_doc ! Privilege to work with excellent PROMISE investigators. https://t.co/fHCMtlcytB

— Maros Ferencik (@CardiacCTGuy) January 22, 2019

Source: JACC