Biomarkers · Cardiac & Hemodynamics
High-Sensitivity Cardiac Troponin I (hs-cTnI)
Lower values go with lower risk of death. No risk curve catalogued yet.
Published risk of death1.23×per 1 SD increase in baseline hs-cTn (all contributing studies measured hs-cTnI) (95% CI 1.08–1.39) · Meta-analysis of general-population studies of hs-cTnT/I (24 studies, 203,202 subjects overall); all-cause death pooled from hs-cTnI studies
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in hs-cTnI, study by study
5 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Supplemental oxygen 8 L/min from paramedic diagnosis of STEMI in normoxic patients, compared with no supplemental oxygen (AVOID trial) | Mean peak troponin 57.4 vs 48.0 ug/L (ratio 1.20, 95% CI 0.92-1.56, P=0.18), not significant; peak creatine kinase significantly higher and infarct size larger at 6 months with oxygen | RCT | Stub D, Smith K, Bernard S, et al. Air Versus Oxygen in ST-Segment-Elevation… |
| pharmacologic | Mavacamten 5 mg daily titrated to plasma levels of 200 or 500 ng/mL for 16 weeks in symptomatic non-obstructive hypertrophic cardiomyopathy (MAVERICK-HCM) | Geometric-mean cTnI falls 34% with mavacamten vs a 4% rise with placebo at 16 weeks (geometric mean differences -0.008 vs +0.001 ng/mL) | RCT | Ho CY, Mealiffe ME, Bach RG, et al. Evaluation of Mavacamten in Symptomatic… |
| pharmacologic | Aficamten titrated daily for 24 weeks in symptomatic obstructive hypertrophic cardiomyopathy (SEQUOIA-HCM biomarker substudy) | hs-cTnI reduced by 41% (95% CI 32-49%) within 8 weeks of aficamten; reverts to baseline after washout | RCT | Coats CJ, Masri A, Barriales-Villa R, et al. Cardiac biomarkers and effects of… |
| pharmacologic | Sacubitril/valsartan 97/103 mg twice daily for 12 months compared with irbesartan 300 mg daily in adults with eGFR 20-60 (UK HARP-III) | Study-average troponin I 16% lower (95% CI 8-23%) than with irbesartan over 12 months; NT-proBNP 18% lower; SBP -5.4 mmHg | RCT | Haynes R, Judge PK, Staplin N, et al. Effects of Sacubitril/Valsartan Versus… |
| pharmacologic | Vutrisiran 25 mg subcutaneously every 3 months for up to 36 months in adults with ATTR cardiomyopathy (HELIOS-B) | Geometric-mean fold-change ratio for troponin I of 0.68 (95% CI 0.62-0.75) vs placebo at month 30; median change -5.8 pg/mL vs +9.7 pg/mL with placebo | RCT | Maurer MS, Berk JL, Damy T, et al. Impact of Vutrisiran on Cardiac Biomarkers… |