Abstract 4037: Predictors of Elevated Troponin T in an Apparently Healthy Older Population: The Rancho Bernardo Study
Background: Minimally elevated levels of cardiac troponin T (cTnT), a marker of cardiac myocyte injury, have been found in small subsets of the general population, but the cause and significance of these rare elevations is controversial. The purpose of this study was to determine the prevalence and predictors of cTnT elevation in a population of community-dwelling older adults.
Methods: cTnT was measured in stored plasma (Elecsys® Troponin T, Roche Diagnostics) from 956 adults age 60–97 (mean 77) who attended a study visit between 1997–99. Participants were divided into 3 groups based on cTnT levels (ng/mL): Undetectable (n = 917), Low (< 0.03, n = 30), and High (≥ 0.03, n = 9). Covariates of elevated cTnT were identified by backwards stepwise logistic regression including variables with significant univariate associations. Odds ratios (OR) for continuous variables are expressed per standard deviation log-base 10 units.
Results: cTnT levels were detectable in 4.1% of the population. Patients with detectable cTnT were more likely to be older (p<0.001) and to have elevated N-terminal pro B-type (NT-proBNP) levels and reduced creatinine clearance (Figure⇓). On multivariate analysis, covariates of detectable cTnT were male sex (OR 2.7, p=0.03), a history of carotid revascularization (OR 10.2, p=0.02), and higher levels of blood urea (OR 1.7, p<0.01), urinary albumin (OR 2.0, p=0.001) and NT-proBNP (OR 2.8, p<0.001).
Conclusions: Patients with detectable cTnT levels even lower than values currently considered abnormal have clinical features suggestive of poor health. Future studies are warranted to determine whether minimally elevated cTnT levels portend a worsened prognosis.