Dynamic Changes in High‐Sensitivity Cardiac Troponin I Levels Associate With Variations in Cardiovascular Risk Scores in the General Population

Background: In the general population, elevated hs-cTnI (high-sensitivity cardiac troponin I) levels are linked to adverse cardiovascular outcomes. Whether changes in hs-cTnI within the normal range are associated with variations in cardiovascular risk scores remains unclear. Methods: This observational substudy of the CV-PREVITAL (Strategies for Primary Cardiovascular Prevention in the Italian Population) project evaluated 810 subjects (522 women) in primary prevention. Hs-cTnI was measured at baseline and after 12 months in 473 participants. Cardiovascular risk was assessed using validated scores along with diet adherence and sleep quality. Clinical and laboratory parameters were recorded. Participants received structured lifestyle counseling. Results: At baseline, hs-cTnI was undetectable in 59% of participants. Detectable hs-cTnI was associated with older age (58 versus 55 years), higher body mass index (26 versus 24 kg/m2), greater waist circumference (91 versus 85 cm), higher blood pressure (129 versus 123 mm Hg), lower high-density lipoprotein cholesterol (56 versus 59 mg/dL), higher glycated hemoglobin (40 versus 38 mmol/mol), all P<0.01. Progetto Cuore, Framingham Risk Score, Atherosclerotic Cardiovascular Disease, and Finnish Diabetes Risk scores were higher (all P<0.0001) in participants with detectable hs-cTnI, whereas the Moli-sani risk score did not differ. At 12 months, participants with undetectable hs-cTnI increased to 79% (P<0.0001). Although all scores but 1 improved at follow-up, changes in hs-cTnI were not consistently associated with changes in risk scores or therapy modifications in exploratory analyses. Conclusions: In this primary-prevention cohort, the presence of detectable hs-cTnI was associated with a less favorable risk profile. However, its usefulness in the longitudinal monitoring of cardiovascular risk changes requires validation against cardiovascular outcomes.