Individual and Joint Associations of High‐Sensitivity Troponin I and High‐Sensitivity Troponin T with Cardiac Phenotypes and Outcomes in the General Population: An Analysis From the Dallas Heart Study

Abstract

Background High‐sensitivity troponin I (hs‐cTnI) and T (hs‐cTnT) provide complementary information regarding cardiovascular disease risk. The explanation for their distinct risk profiles is incompletely understood. Methods and Results hs‐cTnI and hs‐cTnT were measured in Dallas Heart Study participants. Associations of hs‐cTnI and hs‐cTnT with demographics and phenotypes were assessed using linear regression. Associations with incident heart failure, atherosclerotic cardiovascular disease, global cardiovascular disease, and cardiovascular and all‐cause mortality were assessed using Cox models. Among 3276 participants (56% women, 50% Black persons, median age 43 years), the correlation between hs‐cTnI and hs‐cTnT was modest (Spearman rho=0.35). Variables associated with hs‐cTnI but not hs‐cTnT included hypertension, higher body mass index and total cholesterol, and lower high‐density lipoprotein and cholesterol efflux capacity. Older age, male sex, and diabetes were positively associated, and smoking was negatively associated, with hs‐cTnT but not hs‐cTnI. Hs‐cTnI and hs‐cTnT were associated with heart failure (hazard ratio [HR] per SD log hs‐cTnI 1.53 [95% CI, 1.30–1.81] and HR per SD log hs‐cTnT 1.65 [95% CI, 1.40–1.95]), global cardiovascular disease (HR, 1.22 [95% CI, 1.10–1.34] and HR, 1.27 [95% CI, 1.15–1.32]), and all‐cause mortality (HR, 1.12 [95% CI, 1.01–1.25], and HR, 1.17 [95% CI, 1.06–1.29]). After adjustment for N‐terminal pro‐B‐type natriuretic peptide and the alternative troponin, both remained associated with heart failure (HR per SD log hs‐cTnI 1.32 [95% CI, 1.1–1.58] and HR per log hs‐cTnT 1.27 [95% CI, 1.06–1.51]). Conclusions Hs‐cTnI and hs‐cTnT are modestly correlated, demonstrate differential associations with cardiac and metabolic phenotypes, and provide complementary information regarding heart failure risk.

Keywords

• cardiovascular disease
• high‐sensitivity troponins
• risk prediction