The Extent of Coronary Atherosclerosis Is Associated With Increasing Circulating Levels of High Sensitive Cardiac Troponin T

• Published in: Arteriosclerosis, thrombosis, and vascular biology Vol. 30; no. 6; pp. 1269 - 1275
• Main Authors: Laufer, Eduard M, Mingels, Alma M.A, Winkens, Mark H.M, Joosen, Ivo A.P.G, Schellings, Mark W.M, Leiner, Tim, Wildberger, Joachim E, Narula, Jagat, Van Dieijen-Visser, Marja P, Hofstra, Leonard
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01-06-2010; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; C-Reactive Protein - metabolism; Cardiology. Vascular system; Chi-Square Distribution; Coronary Angiography - methods; Coronary heart disease; Coronary Stenosis - blood; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - etiology; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Heart; Humans; Likelihood Functions; Logistic Models; Male; Medical sciences; Middle Aged; Natriuretic Peptide, Brain - blood; Odds Ratio; Peptide Fragments - blood; Predictive Value of Tests; Risk Assessment; Risk Factors; Severity of Illness Index; Tomography, X-Ray Computed; Troponin T - blood; Up-Regulation; Vascular disease; computed tomography; coronary artery disease; Troponin; Atherosclerosis; ischemic heart disease; Myocardial ischemia; Cardiovascular disease; Computerized axial tomography; Myocardial disease; Coronary heart disease; imaging
• ISSN: 1079-5642; 1524-4636
• DOI: 10.1161/ATVBAHA.109.200394

OBJECTIVE—This study explored the relationship between coronary atherosclerotic plaque burden and quantifiable circulating levels of troponin measured with a recently introduced high sensitive cardiac troponin T (hs-cTnT) assay.
METHODS AND RESULTS—Cardiac patients suspected of having coronary artery disease (CAD) but without acute coronary syndrome were studied. Cardiac troponin T levels were assessed using the fifth-generation hs-cTnT assay. All patients (n=615) underwent cardiac computed tomographic angiography (CCTA). On the basis of CCTA, patients were classified as having no CAD or mild (<50% lesion), moderate (50% to 70% lesion), severe (>70% lesion), or multivessel CAD (multiple >70% lesions). As a comparison, high-sensitivity C-reactive protein levels were measured. Progressively increasing hs-cTnT levels were found in patients with mild (median, 4.5 ng/L), moderate (median, 5.5 ng/L), severe (median, 5.7 ng/L), and multivessel (median, 8.6 ng/L) CAD compared with patients without CAD (median, 3.7 ng/L) (all P<0.01). For high-sensitivity C-reactive protein and N-terminal pro-B-type natriuretic peptide, no such relationship was observed. In patients without CAD, 11% showed hs-cTnT levels in the highest quartile, compared with 62% in the multivessel disease group (P<0.05). Multivariance analysis identified hs-cTnT as an independent risk factor for the presence of CAD.
CONCLUSION—In patients without acute coronary syndrome, even mild CAD is associated with quantifiable circulating levels of hs-cTnT.