A pilot project to study troponin I in a representative sample of the region from the ESSE-RF study: distribution among population and associations with risk factors

Aim. To assess the distribution of cardiac troponin I (cTnI) in a sample of the region from the ESSE-RF study and to study its associations with risk factors (RFs) and the Systematic Coronary Risk Evaluation (SCORE) system.

Material and methods. This observational cross-sectional study includes a representative sample of the population aged 25-64 years of the Vologda region (n=1591). The analysis included sex, age, behavioral and cardiometabolic RFs, biomarkers, prior cardiovascular diseases (CVDs), and SCORE. The differences between age-sex groups were considered significant at p<0,05.

Results. According to study results, asymmetry in cTnI distribution among population was revealed. The median cTnI level in the sample was 1,5 pg/ml (95% confidence interval, 0,80-2,50). Noteworthy is the high level of the 99th percentile of cTnI in men aged 45-54 years (55,3 pg/ml). At the same time, the 99th percentile for the entire sample in men was 47,7 pg/ml, while in women — 13,3 pg/ml. The cTnI level log increases significantly with age in both men (p<0,0001) and women (p<0,0001), but faster in men. There was a higher level of cTnI in young men compared to same-age women. In multivariate analysis, significant associations of cTnI levels with sex, age, blood low-density lipoprotein cholesterol, abdominal obesity, hypertension, and brain natriuretic peptide level were obtained. Insufficient accuracy of classification of study participants by SCORE risk was revealed.

Conclusion. The distribution of cTnI in the sample of the Russian region from the ESSE-RF study is sharply shifted to the left (median, 1,5 pg/ml). Higher cTnI levels were revealed in young men compared to their female peers. Significant associations of cTnI with obesity (body mass index, hypertension, elevated low-density lipoprotein cholesterol, and brain natriuretic peptide concentration) were found. It was demonstrated that SCORE does not accurately classify individuals with high and moderate cТnI levels.

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