Witkowski M, Wu Y, Hazen SL, et al. - A heightened long-term adverse cardiovascular event risk is predicted by the presence of subclinical myocardial necrosis, as identified by high-sensitivity cardiac troponin T (hs-cTnT), in cases with stable prediabetes, thus, hs-cTnT levels may aid risk stratification and improve clinical decision making in patients with prediabetes.

• Risk stratification of prediabetes cases is an unmet clinical need.

• This study involved 2,631 stable patients with prediabetes in whom hs-cTnT was analyzed.

• High prevalence of hs-cTnT was evident with a median level of 13 ng/L (interquartile range 8.2–21.6 ng/L).

• Hs-cTnT showed independent link with incident MACE (major adverse cardiac events: death, myocardial infarction, stroke) at 3 years and 5-year mortality.

• In primary and secondary prevention individuals, hs-cTnT independently predicted event risk.