Association between high-sensitive cardiac troponin level and coronary artery disease: A systematic review and meta-analysis

Background and objectives Previous studies suggest a link between high-sensitive cardiac troponin (hs-cTn) levels and coronary artery disease (CAD). However, the nature of this relationship is disputed. To address this, we conducted a study to gather and assess evidence on the association between hs-cTn and CAD prediction. Data sources Studies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After the screening, the selected articles’ quality and risk of bias assessment were evaluated. Synthesis method Meta-analysis calculated std. mean difference on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed. Results Twenty-two studies were included in this systematic review, with a total of 844 cases and 2101 control people. The results of the meta-analysis on nine studies showed a significant and positive association between hs-cTn levels and CAD (pooled std. mean difference = 0.44; 95% confidence interval = 0.14–0.73; p < 0.003), with no publication bias ( p = 0.9170). Among subgroups, std. mean differences were notably different only when the data were stratified by region or risk of bias; however, subgroup analysis could not determine the source of heterogeneity. Conclusions Available prospective studies indicate a strong association of hs-cTn with the risk of CAD and significant improvements in CAD prediction. Further investigations in both molecular and clinical fields with proper methodology and more detailed information are needed to discover more evidence and underlying mechanisms to clear the interactive aspects of hs-cTn level in CAD patients.