Key result
Each log unit increase in hs-cTnI was independently associated with increased odds of having an Agatston score ≥100 among older Asians with well-controlled HIV (OR 2.83; 95% CI 1.69-4.75; P<0.001).
Why the study?
Elevated high-sensitivity cardiac troponin indicates myocardial injury and CAD, but its association with subclinical arteriosclerosis evaluated by coronary calcium scoring among older patients with well-controlled HIV was unclear.
Are elevated high-sensitivity cardiac troponin levels associated with severe subclinical coronary arteriosclerosis in older Asians with well-controlled HIV?
Cross-Sectional (n=337)
Are elevated high-sensitivity cardiac troponin levels associated with severe subclinical coronary arteriosclerosis in older Asians with well-controlled HIV?
In older Asians with well-controlled HIV, elevated hs-cTnI is independently associated with severe subclinical coronary atherosclerosis, suggesting its potential utility as a biomarker for cardiovascular risk stratification in this population.
May flag older virally suppressed HIV patients for CAC imaging; leaves open whether hs-cTn independently improves risk prediction.
Background Elevated levels of high-sensitivity cardiac troponin (hs-cTn) are suggestive of myocardial cell injury and coronary artery disease. We explored the association between hs-cTn and subclinical arteriosclerosis using coronary artery calcification (CAC) scoring among 337 virally suppressed patients with human immunodeficiency virus (HIV) who were ≥50 years old and without evidence of known coronary artery disease. Methods Noncontrast cardiac computed tomography and blood sampling for hs-cTn, both subunit I (hs-cTnI) and subunit T (hs-cTnT), were performed. The relationship between CAC (Agatston score) and serum hs-cTn levels was analyzed using Spearman correlation and logistic regression models. Results The patients, of whom 62% were male, had a median age of 54 years and had been on antiretroviral therapy for a median of 16 years; the CAC score was >0 in 50% of patients and ≥100 in 16%. Both hs-cTn concentrations were positively correlated with the Agatston score, with correlation coefficients of 0.28 and 0.27 (P < .001) for hs-cTnI and hs-cTnT, respectively. hs-cTnI and hs-cTnT concentrations of ≥4 and ≥5.3 pg/mL, respectively, provided the best performance for discriminating patients with Agatston scores ≥100, with a sensitivity and specificity of 76% and 60%, respectively, for hs-cTnI and 70% and 50% for hs-cTnT. In multivariable logistic regression analysis, each log unit increase in hs-cTnI level was independently associated with increased odds of having an Agatston score ≥100 (odds ratio, 2.83 [95% confidence interval, 1.69–4.75]; P <.001). Although not an independent predictor, hs-cTnT was also associated with an increased odds of having an Agatston score ≥100 (odds ratio, 1.58 [95% confidence interval, .92–2.73]; P = .10). Conclusions Among Asians aged ≥50 years with well-controlled HIV infection and without established cardiovascular disease, 50% had subclinical arteriosclerosis. Increasing hs-cTnI and hs-cTnT concentrations were associated with an increased risk of severe subclinical arteriosclerosis, and hs-cTn may be a potential biomarker to detect severe subclinical arteriosclerosis.
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Chattranukulchai et al. (2023) conducted a cross-sectional in Human immunodeficiency virus (HIV) without known coronary artery disease (n=337). High-sensitivity cardiac troponin I (hs-cTnI) was evaluated on Agatston score ≥100 (OR 2.83, 95% CI 1.69-4.75, p=<.001). Each log unit increase in hs-cTnI was independently associated with increased odds of having an Agatston score ≥100 among older Asians with well-controlled HIV (OR 2.83; 95% CI 1.69-4.75; P<0.001).
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