Abstract 3486: Minimally Elevated Cardiac Troponin T Independently Predicts Death in Apparently Healthy Adults: Results from the Rancho Bernardo Study
Background: Minimally elevated levels of cardiac troponin T (TnT), a marker of cardiac myocyte injury, have been found in small subsets of the general population. The significance of these rare elevations is controversial. The purpose of this study was to determine the prognostic value of detectable TnT levels in a population of community-dwelling older adults.
Methods: Prospective community-based study of 375 men and 584 women ages 60 to 97 (mean 77) who had plasma TnT measurements (Elecsys® Troponin T, Roche Diagnostics) at baseline (1997–99) and were followed for mortality through July 2006. Participants were divided into 2 groups based on TnT levels: Undetectable (n = 917) and Detectable (≥ 0.01 ng/ml, n = 39).
Results: The 39 (4.1%) participants with detectable TnT levels were older and were more likely to be men (both p < 0.01) than those with undetectable TnT. Most of those with detectable TnT levels did not have known heart disease at baseline (79%, 95% C.I. 64 – 89%). During an average 6.3 year follow-up, 220 deaths occurred; 42% were cardiovascular (CV). In Cox proportional hazards regressions, participants with detectable TnT had increased risk of all-cause death (HR = 4.6, 95% CI 3.0 –7.1, Figure⇓) and of CV death (HR = 5.6, 95% C.I. 3.0 –10.6). Adjusting for age, sex, lifestyle characteristics, and multiple CV risk factors, as well as exclusion of the 152 participants with known heart disease at baseline, did not materially change the TnT-mortality associations.
Conclusions: Apparently healthy adults with detectable TnT, even at levels not currently considered abnormal, are at increased risk of death. The prognostic value of TnT persists for years.