Application of a High-Sensitivity Cardiac Troponin I Assay to a Health Screen Cohort of Young Asian Women and Association With Cardiovascular Risk Factors

Study Questions:

What is the 99th percentile of cardiac troponin (cTn) in young, apparently healthy Asian women with low cardiovascular risk?

Methods:

The authors chose a female-only cohort because males have a higher risk of cardiovascular disease and because troponin concentrations are higher in healthy men than in women. They measured the high-sensitivity cardiac troponin I (hs-cTnI) assay (Abbott Diagnostics) in nonpregnant women, 20-65 years of age, with no self-reported personal history of heart disease, diabetes, or hypertension, who were hospital staff undergoing a health-screening program.

Results:

The 99th percentile was 4.8 ng/L (95% confidence interval, 4.4-10.4 ng/L), much lower than previously reported for women tested with the same assay (15 ng/L). cTnI concentration was significantly associated with age. cTnI concentration was correlated with systolic blood pressure, body mass index, waist circumference, total cholesterol, low-density lipoprotein cholesterol, triglycerides, and fasting glucose. The mean (standard deviation) cTnI concentration for women was significantly higher in those with [2.2 (0.9) ng/L], than those without metabolic syndrome [1.4 (1.3) ng/ L]. The 10-year risk for coronary heart disease calculated with the Framingham system was also associated significantly with cTnI concentration.

Conclusions:

The authors concluded that, in concert with prior studies, higher cTn concentrations, as measured with hs-cTn assays, are associated with a greater burden of cardiovascular risk.

Perspective:

These are the first data of its kind to be published on Asian women. The values are much lower than those seen in Caucasians. This may reflect the fact that primarily young women were included in this study, screening for disease was better, or there was a real difference in the normal values that need to be applied to Asians. These data are thus an important first step, and suggest caution in extrapolating the values seen in Caucasians to an Asian population.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Atherosclerotic Disease (CAD/PAD), Hypertriglyceridemia, Lipid Metabolism, Nonstatins, Diet, Hypertension

Keywords: Coronary Artery Disease, Sunbathing, Women's Health, Coronary Disease, Skin Pigmentation, Blood Pressure, Glucose, Metabolic Syndrome X, Heart Diseases, Waist Circumference, Cholesterol, Body Mass Index, Diterpenes, Troponin I, Cardiovascular Diseases, Triglycerides, Hypertension, Diabetes Mellitus, Fasting


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