Key result
High-sensitivity cardiac troponin T levels ≥ 0.02 µg/l were significantly associated with a 13.4-fold increased odds of having severe coronary calcification (Agatston score ≥ 400).
Why the study?
The association between high-sensitivity cardiac troponin I and T and coronary calcium concentration evaluated by the Agatston score in suspected CAD remained to be evaluated.
Do high-sensitivity cardiac troponin I and T levels correlate with coronary computed tomography-assessed calcium scoring (Agatston score) in patients with suspected coronary artery disease?
Cross-Sectional (n=76)
Single-blind
No
Do high-sensitivity cardiac troponin I and T levels correlate with coronary computed tomography-assessed calcium scoring (Agatston score) in patients with suspected coronary artery disease?
Odds Ratio: 13.4 (95% CI 1.545–116.233)
p-value: p=0.019
High-sensitivity cardiac troponin I and T levels correlate with coronary artery calcium scores and may help identify patients with subclinical coronary artery disease and high plaque burden.
hs-cTnI/T linked to higher CAC in low-intermediate risk patients; leaves open whether troponin refines CCT-based stratification.
BACKGROUND: This study evaluates the association between high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT) and coronary calcium concentration (CAC) detected by coronary computed tomography (CCT) and evaluated with the Agatston score in patients with suspected coronary artery disease (CAD). METHODS: Patients undergoing CCT during routine clinical care were enrolled prospectively. CCT was indicated for patients with a low to intermediate pretest probability for CAD. Within 24 h of CCT examination, peripheral blood samples were taken to measure cardiac biomarkers hs-cTnI and hs-cTnT. RESULTS: A total of 76 patients were enrolled including 38% without detectable CAC, 36% with an Agatston score from 1 to 100, 17% from 101 to 400, and 9% with values ≥ 400. hs-cTnI was increasing alongside Agatston score and was able to differentiate between different groups of Agatston scores. Both hs-cTn discriminated values greater than 100 (hs-cTnI, AUC = 0.663; p = 0.032; hs-cTnT, AUC = 0.650; p = 0.048). In univariate and multivariate logistic regression models, hs-cTnT and hs-cTnI were significantly associated with increased Agatston scores. Patients with hs-cTnT ≥ 0.02 µg/l and hs-cTnI ≥ 5.5 ng/l were more likely to reveal values ≥ 400 (hs-cTnT; OR = 13.4; 95% CI 1.545-116.233; p = 0.019; hs-cTnI; OR = 8.8; 95% CI 1.183-65.475; p = 0.034). CONCLUSION: The present study shows that the Agatston score was significantly correlated with hs cardiac troponins, both in univariable and multivariable linear regression models. Hs-cTnI is able to discriminate between different Agatston values. The present results might reveal potential cut-off values for hs cardiac troponins regarding different Agatston values. Trial registration Cardiovascular Imaging and Biomarker Analyses (CIBER), NCT03074253 https://clinicaltrials.gov/ct2/show/record/NCT03074253.
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Rusnak et al. (2017) conducted a cross-sectional in Suspected coronary artery disease (n=76). High-sensitivity cardiac troponin T (hs-cTnT) ≥ 0.02 µg/l vs. hs-cTnT < 0.02 µg/l was evaluated on Agatston score ≥ 400 (OR 13.4, 95% CI 1.545-116.233, p=0.019). High-sensitivity cardiac troponin T levels ≥ 0.02 µg/l were significantly associated with a 13.4-fold increased odds of having severe coronary calcification (Agatston score ≥ 400).
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