PEACE: Troponin I levels predicted CV risk in stable CAD

Small increases in troponin I concentrations were linked to CV risks or death in patients with stable CAD, regardless of troponin T levels.

High-sensitivity cardiac troponin I and high-sensitivity cardiac troponin T concentration correlations were moderate, suggesting that the release mechanism differs between the troponins in a chronic setting, according to research published in the Journal of the American College of Cardiology.

Torbjørn Omland

In the biomarker substudy of the PEACE trial, researchers measured troponin I levels in 3,623 patients with stable CAD and preserved systolic function. The majority of patients (98.5%) had concentration levels of troponin I higher than the detection level of 1.2 pg/mL.

Researchers reported a moderate correlation with troponin I and troponin T (r=.044) and N-terminal pro–B-type natriuretic peptide (r=0.39), and a weak correlation with age (r=0.17) and estimated glomerular filtration rate (r=–0.11).

During a median follow-up period of 5.2 years, 203 patients died of CV causes or were hospitalized for HF and 209 patients had nonfatal MI, according to the abstract. Researchers adjusted the analyses for conventional risk markers, N-terminal pro-B-type natriuretic peptide and troponin T, and found that the highest troponin I levels, compared with markers in lower quartiles, were associated with CV death and HF (HR=1.88; 95% CI, 1.33-2.66). The researchers found a significant, weaker association with nonfatal MI (HR=1.44; 95% CI, 1.03-2.01). Using the same models, troponin T concentrations were associated with increased CV death or HF, but not increased MI.

“The main finding of the present study is that small elevations in [troponin I] are associated with the incidence of CV death or HF in patients with stable CAD and provide incremental prognostic information to conventional risk markers and prognostic CV biomarkers, including, [troponin T],” Torbjørn Omland, MD, PhD, MPH, of the department of cardiology at HØKH Research Centre, Akershus University Hospital, Lørenskog, Norway, and colleagues wrote. “Furthermore, [troponin I] but not [troponin T] was significantly and independently associated with both prior acute MI and the incidence of subsequent acute MI.”

For more information:

Omland T. J Am Coll Cardiol. 2013;doi:10.1016/j.jacc.2012.12.026.

Disclosure: The PEACE trial was sponsored by Abbott Laboratories, Knoll Pharmaceuticals and the National Heart, Lung and Blood Institute. See the full study for a list of the researchers’ relevant financial disclosures.