Tobacco Consumption and High‐Sensitivity Cardiac Troponin I in the General Population: The HUNT Study

Background Cardiac troponins represent a sensitive index of subclinical myocardial injury and are associated with increased risk of cardiovascular events in the general population. Despite positive associations with cardiovascular risk of both cardiac troponins and cigarette smoking, concentrations of cardiac troponin I measured by high‐sensitivity assays (hs‐cTnI) are paradoxically lower in current smokers than in never‐smokers. The impact of smoking intensity and time from smoking cessation on hs‐cTnI remains unknown. Methods and Results hs‐cTnI concentrations were measured in 32028 subjects free from cardiovascular disease enrolled in the prospective, population‐based HUNT (Trøndelag Health Study). Tobacco habits were self‐reported and classified as never (n=14 559), former (n=14 248), and current (n=3221) smokers. Current smokers exhibited significantly lower concentrations of hs‐cTnI than never‐smokers ( P <0.001). In adjusted models, both current smoking (−17.3%; 95% CI, −20.6 to −13.9%) and former smoking (−6.6%; 95% CI, −8.7 to −4.5%) were associated with significantly lower hs‐cTnI concentrations. Among former smokers, higher smoking burden (>10 pack‐years) were associated with lower concentrations of hs‐cTnI. Time since smoking cessation was associated with increasing concentrations of hs‐cTnI in a dose‐dependent manner ( P for trend<0.001), and subjects who quit smoking >30 years ago had concentrations of hs‐cTnI comparable with those of never‐smokers. Conclusions In the general population, both current and former cigarette smoking is associated with lower concentrations of hs‐cTnI. In former smokers, there was a dose‐response relationship between pack‐years of smoking, and hs‐cTnI. Time since smoking cessation was associated with increasing concentrations of hs‐cTnI, indicating a continuum of hs‐cTnI from current smoker to never‐smokers.

Evaluation of the Correlation Between Cardiac Troponin I Versus Causes of Admission and In-Hospital Mortality in End-Stage Renal Disease Patients

Objectives: There are arguments regarding the relationship between the level of cardiac troponin I (cTnI) and presence of cardiac diseases in end-stage renal disease (ESRD) patients. This study aimed to determine the relationship between positivity of cTnI and cause of admission and patients’ outcome in ESRD patients. Methods: In this cross-sectional study, all ESRD patients who had checked cTnI and admitted to two university hospitals in Isfahan, Iran were enrolled. The patients’ demographic characteristics, cause of admission, and outcome were correlated with cTnI positivity. Results: Out of a total of 348 ESRD patients, 100 subjects had positive cTnI. There was a positive correlation between age and admission in Al-Zahra hospital with positive cTnI. In contrast, vascular access complication and hypertension had a negative correlation with positivity of cTnI. The results of multiple logistic regression analysis showed that factors including age (OR: 1.04; 95% CI: 1.01 - 1.07; P: 0.004) and infections (OR: 3.1; 95% CI: 1.3 - 7.3; P: 0.009) were associated with increased risk of in-hospital mortality. In contrary, exit site infection (OR: 0.11; 95% CI: 0.01 - 0.8; P: 0.03) and hypertension (OR = 0.32; 95% CI: 0.14 - 0.77; P = 0.01) were associated with decreased risk of mortality. Although cTnI positivity correlated with patients’ in-hospital mortality (OR = 2.038). Conclusions: Although positive cTnI had a borderline association with in-hospital mortality in ESRD patients, further multicenter studies with larger sample size are required to confirm the results.

Abdominal aortic calcification, cardiac troponin I and atherosclerotic vascular disease mortality in older women

ObjectiveExamine if two inexpensive measures of atherosclerotic vascular diseases (ASVD), abdominal aortic calcification (AAC) and high-sensitivity cardiac troponin I (hs-cTnI) provide complementary information for 10-year ASVD mortality and all-cause mortality risk in older women.Methods908 community-dwelling women without prevalent ASVD (≥75 years) were followed-up between 2003 and 2013. AAC and plasma hs-cTnI measures were obtained in 2003. AAC was assessed on lateral spine images using a semiquantitative method (AAC24). Linked health records were used for mortality outcomes.ResultsMean±SD age was 79.9±2.6 years. 276 (30.4%) women died during follow-up, including 138 (15.2%) ASVD-related deaths. AAC24 and hs-cTnI were independently associated with ASVD and all-cause mortality (p<0.001). The cohort was dichotomised into four groups: (1) low AAC24 (AAC24: 0 or 1) and <median hs-cTnI (n=163, referent), (2) moderate-extensive AAC24 (AAC24:>1) and <median hs-cTnI (n=280), (3) low AAC24 and ≥median hs-cTnI (n=148) and (4) moderate-extensive AAC24 and ≥median hs-cTnI (n=317). Compared with the referent group, a stepwise increase in relative hazard (HR (95% CI)) for ASVD mortality was seen at 2.39 (1.05 to 5.46), 3.18 (1.35 to 7.79) and 5.38 (2.44 to 11.85), respectively. A similar associations were observed for all-cause mortality, at 1.58 (0.99–2.52), 2.38 (1.46–3.89) and 3.02 (1.93–4.72), respectively (all p<0.05).ConclusionHigher AAC and elevated hs-cTnI were associated with higher risk of ASVD mortality and all-cause mortality, independent of each other. Stratifying by moderate to extensive AAC and elevated hs-cTnI identified women at very high risk. Further studies investigating whether combining factors may improve risk prediction are needed.Trial registration numberACTRN12617000640303.