Role of High-Sensitivity Troponins in Cardiovascular Risk Assessment in Asymptomatic Adults: A Systematic Review

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Published Apr 1, 2026
https://doi.org/10.62438/tunismed.v104i02.6337
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Vol. 104 No. 02 (2026): Tunis Med Fev 2026

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Abderrazak Sabri
Immunology Laboratory, Clinic of Infectious Diseases and Autoimmunity, Faculty of Medicine and Pharmacy, Hassan II University, Clinical Biochemistry Laboratory, Ibn Rochd University Hospital, Casablanca, Morocco
Mohamed Omari
Laboratory for Healthcare and Sustainable Development (2s2d). Team 3: Health Sciences, Education and Management (2sem), Higher Institute of Nursing and Health Care Professions, Casablanca, Morocco.
Hind Kechkar
Immunology Laboratory, Clinic of Infectious Diseases and Autoimmunity, Faculty of Medicine and Pharmacy, Hassan II University, Clinical Biochemistry Laboratory, Ibn Rochd University Hospital, Casablanca, Morocco
Ahmed Aziz Bousfiha
Clinical Immunology Laboratory for Infection and Autoimmunity, Faculty of Medicine and Pharmacy, Hassan II University, Department of Paediatric Infectious Diseases and Clinical Immunology, Abderrahim Harouchi Mother and Child Hospital, Ibn Rochd University Hospital Centre, Casablanca, Morocco
Nabiha Kamal
Immunology Laboratory, Clinic of Infectious Diseases and Autoimmunity, Faculty of Medicine and Pharmacy, Hassan II University, Clinical Biochemistry Laboratory, Ibn Rochd University Hospital, Casablanca, Morocco

Abstract

Introduction : The causal relationship between high-sensitivity troponins (hs-cTn) and cardiovascular risk in asymptomatic adults remains incompletely established. The objective of this systematic review is to evaluate the prognostic value of hs-cTn (hs-cTnI and hs-cTnT) in the general population free of clinical cardiovascular disease, and their potential to enhance the prediction of future cardiovascular risk when incorporated into conventional cardiovascular risk stratification models.


Methods : The literature search was conducted in the following electronic databases: PubMed, Google Scholar, ScienceDirect, and SpringerLink, to identify prospective cohort studies published between January 1, 2016, and February 28, 2024, examining the relationship between hs-cTn and cardiovascular risk in asymptomatic adult populations. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).


Results : The 19 studies included in this review involved a total of 250,513 participants. The results confirm a significant association between hs-cTn levels and cardiovascular events. The addition of these biomarkers to traditional risk prediction models often enhances their predictive performance, as evidenced by increases in the C-index (Concordance index), Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI). hs-cTnI and hs-cTnT were moderately or weakly correlated but complementary, as they were associated with different types of cardiovascular events.


Conclusion : The inclusion of hs-cTn in predictive scores slightly improves their predictive accuracy. Nevertheless, it remains necessary to demonstrate their clinical benefit through randomized trials before incorporating them into routine practice.

Keywords:

Cardiovascular disease, High-sensitivity Troponin, Cardiovascular risk, Systematic review

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Author Biographies

Ahmed Aziz Bousfiha, Clinical Immunology Laboratory for Infection and Autoimmunity, Faculty of Medicine and Pharmacy, Hassan II University, Department of Paediatric Infectious Diseases and Clinical Immunology, Abderrahim Harouchi Mother and Child Hospital, Ibn Rochd University Hospital Centre, Casablanca, Morocco

Laboratoire d’Immunologie Clinique Infection et Auto-immunité, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Maroc.

Service des Maladies infectieuses pédiatriques et Immunologie clinique, Hôpital Mère-Enfant Abderrahim HAROUCHI, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc.

Nabiha Kamal, Immunology Laboratory, Clinic of Infectious Diseases and Autoimmunity, Faculty of Medicine and Pharmacy, Hassan II University, Clinical Biochemistry Laboratory, Ibn Rochd University Hospital, Casablanca, Morocco

Laboratoire d’Immunologie Clinique Infection et Auto-immunité, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Maroc.

Laboratoire de Biochimie clinique, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc.

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