ABSTRACT
OBJECTIVE: Ascertain the prevalence of elevated Troponin I levels in applicants for insurance to assess the utility of routine measurement of Troponin I in this population. BACKGROUND: Patients presenting with chest pain, who are determined not to be experiencing an acute coronary event, but are noted to have increased levels of Troponin have higher mortality rates than a control population. Elevated levels of Tropoins in the general population are also associated with increase in all cause mortality. Therefore elevated Troponin levels in asymptomatic individuals could be considered a cardiac risk marker. METHODS: Blood samples from Insurance applicants and Health & Wellness participants were analyzed for Troponin I by the Siemens ADVIA Centaur immunoanalyzer. Since such samples are in transit for a day, we determined the rate of degradation of Troponin I on 24-hour storage at room temperature and extrapolated the time-zero values. RESULTS: About 1.5% (10 of 697) of the patients had Troponin levels above 0.04 ng/mL. This rate is higher than would be expected in a healthy general population. Three samples (0.43%) had levels > 0.06 ng/mL, which would be considered elevated and indicative of myocardial injury. CONCLUSIONS: Given the low percentage Troponin I elevations in the general population applying for life insurance, it may not be cost effective to routinely measure Troponin I levels in blood specimens submitted for insurance purposes, except for high value policies. It may be prudent collect data on Troponin I levels in Insurance applicants for better defining the risk models of cardiovascular disease.
