Evidence mapPaperPMID 40204376Full record

SynthesisJournal of the American College of Cardiology2025

Cardiac Troponins and Cardiovascular Disease Risk Prediction: An Individual-Participant-Data Meta-Analysis.

Anoop S V Shah, Spencer J Keene, Lisa Pennells, Stephen Kaptoge, Dorien M Kimenai, Matthew Walker, Julianne D Halley, Sara Rocha, Ron C Hoogeveen, Vilmundur Gudnason and 19 more

Abstract readMeta-Analysis
In one paragraph

Synthesis in Journal of the American College of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Troponin Testing for Cardiovascular Primary Prevention Decision Making?Journal of the American College of Cardiology · 2025
    Article
  8. A global prediction of cardiovascular disease from 2020 to 2030.Frontiers in cardiovascular medicine · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Anoop S V ShahDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Cardiology, Imperial College NHS Trust, London, United Kingdom.
Spencer J KeeneBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, United Kingdom. Electronic address: sjk98@cam.ac.uk.
Lisa PennellsBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom.
Stephen KaptogeBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom.
Dorien M KimenaiBritish Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
Matthew WalkerBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom.
Julianne D HalleyBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom.
Sara RochaBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom.
Ron C HoogeveenDepartment of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Vilmundur GudnasonIcelandic Heart Association, Kopavogur, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Stephan J L BakkerDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Sasiwarang G WannametheeDepartment of Primary Care and Population Health, UCL, London, United Kingdom.
Manan PareekCenter for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Kai M EggersDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
J Wouter JukemaDepartment of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Netherlands Heart Institute, Utrecht, the Netherlands.
Graeme J HankeyCentre for Neuromuscular and Neurological Diseases, The University of Western Australia, Perth, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia.
James A deLemosUT Southwestern Medical Center, Cardiology, Dallas, Texas, USA.
Ian FordRobertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom.
Torbjørn OmlandK. G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.
Magnus Nakrem LyngbakkenK. G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.
Bruce M PsatyCardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
Christopher R deFilippiInova Schar Heart and Vascular, Falls Church, Virginia, USA.
Angela M WoodBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, United Kingdom; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, United Kingdom; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom; Cambridge Centre of Artificial Intelligence in Medicine, Cambridge, United Kingdom; British Heart Foundation Data Science Centre, Health Data Research UK, London, United Kingdom.
John DaneshBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, United Kingdom; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, United Kingdom; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom; Department of Human Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom.
Paul WelshSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Naveed SattarSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Nicholas L MillsBritish Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
Emanuele Di AngelantonioBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, United Kingdom; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, United Kingdom; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom; Health Data Science Research Centre, Human Technopole, Milan, Italy.
CAPRICE Co-Investigators

Funding

Multi-Ethnic Study of Atherosclerosis (MESA) StudyR01HL071205 · CEDARS-SINAI MEDICAL CENTER · 2003 to 2005
$5.8M
The ARIC and Neurocognitive Longitudinal StudyR01HL070825 · UNIVERSITY OF MISSISSIPPI MEDICAL CENTER · 2002 to 2004
$5.1M
Exceptional aging: 12 year trajectories to functionR01AG023629 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2004 to 2005
$2.6M
Infrastructure for mentored access to CHS data and specimensR01HL172803 · UNIVERSITY OF WASHINGTON · 2025 to 2025
$1.4M
MESA Family Study - Columbia University Field CenterR01HL071252 · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2003 to 2005
$1.1M
CHS Events Follow-up StudyU01HL080295 · UNIVERSITY OF WASHINGTON · 2005 to 2005
$1.1M
MESA Family StudyR01HL071250 · NORTHWESTERN UNIVERSITY · 2003 to 2005
$852k
MESA Family StudyR01HL071258 · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2003 to 2005
$780k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095166 · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · 1999 to 2001
$758k
MESA Family StudyR01HL071259 · JOHNS HOPKINS UNIVERSITY · 2003 to 2005
$757k
MESA Family StudyR01HL071051 · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2003 to 2005
$753k
MESA Family StudyR01HL071251 · UNIVERSITY OF MINNESOTA TWIN CITIES · 2003 to 2005
$723k
NCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1 TR001079NCATS NIH HHS UL1 TR001420NCRR NIH HHS UL1 RR024156NHLBI NIH HHS 75N92021D00006NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201100005CNHLBI NIH HHS HHSN268201100006CNHLBI NIH HHS HHSN268201100007CNHLBI NIH HHS HHSN268201100008CNHLBI NIH HHS HHSN268201100009CNHLBI NIH HHS HHSN268201100010CNHLBI NIH HHS HHSN268201100011CNHLBI NIH HHS HHSN268201100012CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS HHSN268201800001CNHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS R01 HL070825NHLBI NIH HHS R01 HL071051NHLBI NIH HHS R01 HL071205NHLBI NIH HHS R01 HL071250NHLBI NIH HHS R01 HL071251NHLBI NIH HHS R01 HL071252NHLBI NIH HHS R01 HL071258NHLBI NIH HHS R01 HL071259NHLBI NIH HHS R01 HL105756NHLBI NIH HHS R01 HL172803NHLBI NIH HHS U01 HL080295NHLBI NIH HHS U01 HL130114NIA NIH HHS R01 AG023629
6 · The paper itself

Abstract

backgroundThe extent to which high-sensitivity cardiac troponin can predict cardiovascular disease (CVD) is uncertain.

objectivesWe aimed to quantify the potential advantage of adding information on cardiac troponins to conventional risk factors in the prevention of CVD.

methodsWe meta-analyzed individual-participant data from 15 cohorts, comprising 62,150 participants without prior CVD. We calculated HRs, measures of risk discrimination, and reclassification after adding cardiac troponin T (cTnT) or I (cTnI) to conventional risk factors. The primary outcome was first-onset CVD (ie, coronary heart disease or stroke). We then modeled the implications of initiating statin therapy using incidence rates from 2.1 million individuals from the United Kingdom.

resultsAmong participants with cTnT or cTnI measurements, 8,133 and 3,749 incident CVD events occurred during a median follow-up of 11.8 and 9.8 years, respectively. HRs for CVD per 1-SD higher concentration were 1.31 (95% CI: 1.25-1.37) for cTnT and 1.26 (95% CI: 1.19-1.33) for cTnI. Addition of cTnT or cTnI to conventional risk factors was associated with C-index increases of 0.015 (95% CI: 0.012-0.018) and 0.012 (95% CI: 0.009-0.015) and continuous net reclassification improvements of 6% and 5% in cases and 22% and 17% in noncases. One additional CVD event would be prevented for every 408 and 473 individuals screened based on statin therapy in those whose CVD risk is reclassified from intermediate to high risk after cTnT or cTnI measurement, respectively.

conclusionsMeasurement of cardiac troponin results in a modest improvement in the prediction of first-onset CVD that may translate into population health benefits if used at scale.

Indexed as

Cardiovascular DiseasesTroponin ITroponin TBiomarkersFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedRisk AssessmentRisk FactorsBiomarkersHydroxymethylglutaryl-CoA Reductase InhibitorsTroponin ITroponin Tbiomarkerscardiac troponinprimary preventionrisk stratification

Identifiers

PMID40204376
PMCPMC13266502

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.