High-sensitive cardiac troponin I (hs-cTnI) values in patients with stable cardiovascular disease: An initial foray

Background: How to use the information from novel high sensitivity troponin assays in stable cardiac patients is unclear. Preliminary data from randomized controlled trial analyses suggest it helps with risk stratification. We investigated the determinants, diagnostic impact and prognostic value of a novel high-sensitive cardiac troponin I (hs-cTnI) assay in patients with stable cardiac disease. Methods: hs-cTnI was measured with a pre-commercial assay in 222 outpatients after clinical testing before cardiac catheterization. Mean follow-up was 1103. ±. 299 days. Results: hs-cTnI was detectable in all patients (median (interquartile range) 6.20 (4.85;8.25) ng/l). Creatinine (p<. 0.001), systolic wall stress (p= 0.004), the presence of myocardial impairment (p= 0.049) and coronary artery stenosis ≥70% (p= 0.050) were predictors of hs-cTnI concentration.hs-cTnI values could not distinguish elevations due to myocardial abnormalities from those related to coronary artery abnormalities. Patients with elevations above the 99th percentile had a higher rate of hospitalizations but otherwise prognosis was not predicted robustly by hs-cTnI values. Conclusion: Stable cardiovascular patients have detectable hs-cTnI concentrations irrespective of their underlying disease. In this heterogeneous group of patients with diverse etiologies for cardiac disease, values were not helpful in distinguishing the etiology of the elevations or in predicting prognosis.