Cardiac troponin I in a representative sample of the Kyrgyz Republic population: distribution, ethnic differences, and association with risk factors
https://doi.org/10.18705/1607-419X-2022-28-6-79-90
Abstract
Objective. To assess the distribution of cardiac troponin I (cTnI) in a sample of the Kyrgyz Republic population, to study its associations with risk factors and to identify the possible ethnic differences. Design and methods. This observational cross-sectional study includes a representative sample of the Kyrgyz Republic population aged 20–64 years (n = 1256). The analysis of cTnI levels in the population and associations of cTnI levels with socio-demographic parameters (sex, age, education, etc.), risk factors (smoking, obesity, hypertension, etc.), blood biochemical parameters (triglycerides, lipid profile, glucose) and an anamnesis of cardiovascular diseases and total cardiovascular risk according to the SCORE scale. The statistical significance level was considered equal to 0,05. Results. The median cTnI level in the Kyrgyz sample was 0,90 pg/ml [0,40; 1,80]. The 99th percentile for the entire sample was 21,4 pg/ml in men and 12,2 pg/ml in women. The median cTnI in the Slavs sample was 1,40 pg/ml [0,60; 2,20]. The 99th percentile for the entire sample was 21,2 pg/ml in men and 25,2 pg/ml in women. The cTnI level log increases significantly with age in both men and women. At the age of 20-30 years, the cTnI level in men is higher than in women in both ethnic groups. However, with age, the increase rate of cTnI in women is higher than in men in both ethnic groups. In a multivariate analysis, significant associations of cTnI levels with sex, age, hypertension, stroke, blood levels of total cholesterol and triglycerides were obtained. Insufficient accuracy of classification of study participants by SCORE risk was revealed. Conclusions. cTnI is a potential strong biomarker that complements traditional risk scales and is applicable in the framework of cardiovascular diseases primary prevention strategies, which was confirmed in this study on the Kyrgyz Republic population.
Keywords
About the Authors
А. V. KontsevayaRussian Federation
Anna V. Kontsevaya, MD, PhD, DSc, Deputy Director for Scientific and Analytical Work, Head, Department of Public Health Promotion
A. G. Polupanov
Kyrgyzstan
Andrey G. Polupanov, MD, PhD, DSc, Professor, Head, Research Group of the Arterial Hypertension Department
D. K. Mukaneeva
Russian Federation
Dinara K. Mukaneeva, MD, Researcher at the Department of Public Health Promotion
V. A. Kutsenko
Russian Federation
Vladimir A. Kutsenko, Senior Researcher, Laboratory of Biostatistics; Postgraduate Student, Department of Probability Theory, Faculty of Mechanics and Mathematics
E. B. Yarovaya
Russian Federation
.lena B. Yarovaya, Doctor of Physical and Mathematical Sciences, Head, Biostatistics Laboratory; Professor, Probability Theory Department, Faculty of Mechanics and Mathematics
M. T. Duishenalieva
Kyrgyzstan
Myskal T. Duishenalieva, MD, Researcher, Department of Arterial Hypertension
A. V. Belinova
Kyrgyzstan
Anna V. Belinova, MD, Postgraduate Student, Department of Therapy No. 2 specialty “Medical Business”
Zh. A. Mamasaidov
Kyrgyzstan
Zhakhongir A. Mamasaidov, MD, PhD, Associate Professor, Department of Therapy No. 2 specialty “Medical Science”
O. M. Drapkina
Russian Federation
Oksana M. Drapkina, MD, PhD, DSc, Professor, Academician of the Russian Academy of Sciences, Director
References
1. World Heart Organization fact sheets: cardiovascular disease [cited 2022 Dec 9]. Available from: https://www.who.int/en/news-room/fact-sheets/detail/cardiovasculardiseases-(cvds)
2. Republican Medical Information Center [cited 2022 Dec 9]. Available from: http://cez.med.kg
3. Gerszten RE, Wang TJ. The search for new cardiovascular biomarkers. Nature. 2008 Feb 21;451(7181):949-52. doi: 10.1038/nature06802
4. Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003 Aug 20;290(7):898-904. doi:10.1001/jama.290.7.898
5. Thygesen K, Alpert JS, Jaffe AS, Chaitmanet BR, Bax JJ, Morrow DA et al. ESC Scientific Document Group. Fourth universal definition of myocardial infarction (2018). Eur Heart J 2019;40:237–269. doi:10.1093/eurheartj/ehy462
6. Blankenberg S, Salomaa V, Makarova N, Ojeda F, Wild P, Lackner KJ et al. Troponin I and cardiovascular risk prediction in the general population: the BiomarCaRE consortium. Eur Heart J. 2016 Aug 7;37(30):2428-37. doi:10.1093/eurheartj/ehw172
7. Farmakis D, Mueller C, Apple FS. High-sensitivity cardiac troponin assays for cardiovascular risk stratification in the general population. Eur Heart J. 2020 Nov 1;41(41):4050-4056. doi: 10.1093/eurheartj/ehaa083
8. Farmakis D., Andreadou I., Aessopos A. High-sensitivity troponin assays: Ready for prime-time use as surrogates of subclinical myocardial injury? J. Am. Coll. Cardiol. 2012; 60(2):166. doi:10.1016/j.jacc.2012.02.058
9. Hughes MF, Ojeda F, Saarela O, Jørgensen T, Zeller T, Palosaari T et al. Association of Repeatedly Measured High-Sensitivity-Assayed Troponin I with Cardiovascular Disease Events in a General Population from the MORGAM/BiomarCaRE Study. Clin Chem. 2017 Jan;63(1):334-342. doi: 10.1373/clinchem.2016.261172
10. Jia X, Sun W, Hoogeveen RC, Nambi V, Matsushita K, Folsom AR et al. High-sensitivity troponin I and incident coronary events, stroke, heart failure hospitalization, and mortality in the Atherosclerosis Risk in Communities (ARIC). Study. Circulation. 2019;139(23):2642-53. doi:10.1161/ CIRCULATIONAHA.118.038772
11. Sigurdardottir FD, Lyngbakken MN, Holmen OL, Dalen H, Hveem K, Røsjø H et al. Relative prognostic value of cardiac troponin I and C-reactive protein in the general population (from the HUNT Study). Am J Cardiol. 2018;121:949-55. doi:10.1016/j.amjcard.2018.01.004
12. Willeit P, Welsh P, Evans JDW, Tschiderer L, Boachie C, Jukema JW et al. High-Sensitivity Cardiac Troponin Concentration and Risk of First-Ever Cardiovascular Outcomes in 154,052 Participants. JACC. 2017;70:558-68. doi:10.1016/j.jacc.2017.05.062
13. Everett BM, Zeller T, Glynn RJ, Ridker PM, Blankenberg S. High-sensitivity cardiac troponin I and B-type natriuretic Peptide as predictors of vascular events in primary prevention: impact of statin therapy. Circulation. 2015;131(21):1851-60. doi:10.1161/ CIRCULATIONAHA.114.014522
14. Shalnova SA, Drapkina OM, Kontsevaya AV, Yarovaya EB, Kutsenko VA, Metelskaya VA et al. 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. Cardiovascular Therapy and Prevention. 2021;20(4):2940. In Russian. doi:10.15829/1728-8800-2021-2940
15. Shalnova SA, Drapkina OM, Kontsevaya AV, Yarovaya EB, Kutsenko VA, Metelskaya VA, et al. Pilot project to study the association of troponin I with cardiovascular events in the population of Russian region. Cardiovascular Therapy and Prevention. 2021;20(5):2980. In Russian. doi:10.15829/1728-8800-2021-2980
16. Kontsevaya AV, Myrzamatova AO, Polupanov AG, Alikhanova KA, Kashirin AK, Khalmatov AN. Ethnic specifics of the main cardiovascular risk factors prevalence among rural inhabitants of a Russian region and regions of Kyrgyzstan and Kazakhstan. Russian Journal of Cardiology. 2017;(6):113-121. In Russian. doi:10.15829/1560-4071-2017-6-113-121
17. Myrzamatova AO, Kontsevaya AV, Polupanov AG, Altymysheva AT, Kashirin AK, Sirotko ML, et al. Results of a 7-year prospective follow-up in the Interepid study: factors influencing all-cause and cardiovascular mortality in rural residents of Russia and the Kyrgyz Republic. Russian Journal of Cardiology. 2022;27(5):4999. In Russian. doi:10.15829/1560-4071-2022-4999
18. Myrzamatova AO, Kashirin AK, Kontsevaya AV, Sirotko M, Mukaneeva DK, Khudyakov MB. Seven-Year Survival and Associations of Risk Factors with All-Cause and Cardiovascular Mortality among Rural Residents of Samara Region. Ekologiya cheloveka (Human Ecology). 2021, 12, pp. 23-29. In Russian. doi: 10.33396/1728-0869-2021-12-23-29
19. Januzzi JL Jr, Mahler SA, Christenson RH, Rymer J, Newby LK, Body R et al. Recommendations for Institutions Transitioning to High-Sensitivity Troponin Testing: JACC Scientific Expert Panel. J Am Coll Cardiol. 2019 Mar 12;73(9):1059-1077. doi: 10.1016/j.jacc.2018.12.046
20. Romiti GF, Cangemi R, Toriello F, Ruscio E, Sciomer S, Moscucci F et al. Sex-Specific Cut-Offs for High-Sensitivity Cardiac Troponin: Is Less More? Cardiovasc Ther. 2019:9546931. doi:10.1155/2019/9546931
21. Welsh P, Preiss D, Hayward C, Shah ASV, McAllister D, Briggs A et al. Cardiac Troponin T and Troponin I in the General Population. Circulation. 2019 Jun 11;139(24):2754-2764. doi: 10.1161/CIRCULATIONAHA.118.038529
22. Leite L, Matos P, Leon-Justel A, Espírito-Santo C, Rodríguez-Padial L, Rodrigues F et al. High sensitivity troponins: A potential biomarkers of cardiovascular risk for primary prevention. Front Cardiovasc Med. 2022 Nov 30;9:1054959. doi: 10.3389/fcvm.2022.1054959
23.
Supplementary files
Review
For citations:
Kontsevaya А.V., Polupanov A.G., Mukaneeva D.K., Kutsenko V.A., Yarovaya E.B., Duishenalieva M.T., Belinova A.V., Mamasaidov Zh.A., Drapkina O.M. Cardiac troponin I in a representative sample of the Kyrgyz Republic population: distribution, ethnic differences, and association with risk factors. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2023;29(1):79-90. (In Russ.) https://doi.org/10.18705/1607-419X-2022-28-6-79-90