High-Sensitivity Cardiac Troponin I and Frailty: Associations with the Frailty Index and Fried Phenotype in Older Women

Pratt, Jedd ORCID: https://orcid.org/0000-0002-7410-078X, Gebre, Abadi, Toro-Huamanchumo, Carlos J., Dent, Elsa, Bozanich, Trent, Lim, Wai E., Byrnes, Elizabeth, McDonagh, Julee, Ferguson, Caleb, Sale, Craig ORCID: https://orcid.org/0000-0002-5816-4169, Zhu, Kun, Schultz, Carl, Prince, Richard L., Lewis, Joshua R. and Sim, Marc (2025) High-Sensitivity Cardiac Troponin I and Frailty: Associations with the Frailty Index and Fried Phenotype in Older Women. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences. glaf235. ISSN 1079-5006

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Abstract

Despite the nexus between cardiovascular health and frailty, the relevance of high-sensitivity cardiac troponin I (hs-cTnI), a biomarker of myocardial injury, to frailty is poorly understood. We examined whether hs-cTnI concentrations were associated with frailty in a well-characterised cohort of older women. A total of 1,151 community-dwelling women from the Perth Longitudinal Study of Aging Women (mean age±SD = 75.2 ± 2.7 years) were included. Frailty was operationalised using a validated Frailty Index (FI) of cumulative deficits, and a modified Fried phenotype. Plasma hs-cTnI were categorised into quartiles. Cross-sectional associations between hs-cTnI quartiles and frailty were assessed using multivariable-adjusted logistic regression models. A total of 235 (20.4%) women were classified as frail using the FI, while 74 (6.4%) were considered frail by Fried’s phenotype. In a multivariable-adjusted model, compared to women in the lowest hs-cTnI quartile (Q1), those in Q3 and Q4 had 1.38 (95%CI 1.00-1.90) and 1.79 (1.20-2.67) greater odds for frailty when classified by the FI. When classified according to Fried’s phenotype, women in Q2, Q3, and Q4 had 2.25 (1.10-4.09), 2.64 (1.19-5.21), and 2.44 (1.10-5.33) greater odds for frailty, compared to Q1. Associations remained largely unchanged when further adjusted for daily protein intake or systemic inflammation (lipocalin-2) and restricted to those with subclinical hs-cTnI levels (<15.6ng/L). Higher hs-cTnI levels are associated with greater odds for frailty, classified using a FI or Fried’s phenotype, amongst older women. hs-cTnI may have applications beyond its typical use in cardiology, offering insight into the implications of underlying cardiovascular dysfunction relating to frailty.