Prognostic Value of High‑Sensitivity Cardiac Troponin İ for Major Adverse Cardiovascular Events and Revascularization in a Prospective Cohort from Azerbaijan

Abstract

Background: High-sensitivity cardiac troponin I (hs-cTnI) enables detection of preclinical myocardial injury and may improve cardiovascular risk stratification beyond traditional markers. However, its prognostic value for major adverse cardiovascular events (MACE) and coronary revascularization in stable populations remains insufficiently defined.
Methods: In this prospective cohort study, adults free of acute coronary syndromes at enrollment were followed for incident MACE and revascularization. Baseline hs-cTnI levels were measured alongside inflammatory (CRP), thrombotic (D-dimer), and cardiorenal (NT-proBNP, microalbuminuria) biomarkers. Clinical characteristics were compared between hs-cTnI positive and negative groups using non-parametric statistics. Logistic regression models were applied to estimate odds ratios (ORs), stratified by gender and adjusted for confounders.
Results: hs-cTnI positivity was observed in approximately one-third of participants and was associated with older age, higher body weight, and greater waist circumference (p < 0.05). Positive individuals exhibited substantially higher levels of CRP, D-dimer, and NT-proBNP (all p < 0.001), whereas microalbuminuria did not differ significantly. In gender-stratified models, hs-cTnI was significantly associated with revascularization in men (OR ~1.9), but not in women. In the overall cohort, hs-cTnI independently predicted revascularization (OR ~1.5) and demonstrated moderate prognostic value for incident MACE. NT-proBNP showed an inverse association with revascularization risk in men, whereas D-dimer and microalbuminuria were not predictive.
Conclusions: Elevated hs-cTnI was associated with adverse cardiometabolic profiles and revascularization risk, supporting its potential value as a marker of preclinical myocardial injury and cardiovascular risk stratification.