Severe multivessel coronary artery disease and high-sensitive troponin T
Inga Magdalena Huziuk1, Małgorzata Lelonek1
1Department of Cardiology, Medical University, Lodz, Poland.
Insights
High-sensitive troponin T (hsTnT) is a key indicator for identifying severe multivessel coronary artery disease (CAD) in stable men. Elevated hsTnT levels independently predict the risk of multivessel CAD.
Area of Science:
- Cardiology
- Biomarker Research
- Diagnostic Imaging
Background:
- Identifying severe multivessel coronary artery disease (CAD) in stable patients non-invasively remains a challenge.
- Biomarkers like C-reactive protein (hsCRP) and high-sensitive troponin T (hsTnT) may aid in risk stratification.
Purpose of the Study:
- To identify factors associated with multivessel CAD in clinically stable men.
- To evaluate the role of hsTnT and fasting glucose in predicting multivessel CAD.
Main Methods:
- Study included 92 symptomatic men with preserved left ventricular function undergoing coronary angiography.
- Patients were grouped into those with (n=46) and without (n=46) multivessel CAD.
Main Results:
- Multivessel CAD patients had significantly higher hsTnT and fasting glucose levels.
- hsTnT ≥ 0.0085 ng/ml and fasting glucose ≥ 5.85 mmol/l were identified as cut-off points.
- Elevated hsTnT was an independent predictor of multivessel CAD (OR 4.286).
Conclusions:
- In men with stable CAD and preserved left ventricular function, elevated hsTnT is independently associated with multivessel coronary artery disease.
- hsTnT serves as a valuable biomarker for risk stratification in this patient group.
Introduction:
A key problem in stable coronary artery disease (CAD) is non-invasive identification of patients with severe multivessel CAD. Determination of biomarkers that have pro-inflammatory properties (C-reactive protein - hsCRP) and indicate heart muscle ischemia (high-sensitive troponin T - hsTnT) can contribute to the improvement of stratification in this regard.
The Aim Of The Study:
The aim of the study was to identify factors associated with the presence of multivessel CAD in clinically stable men.
Material And Methods:
The study included 92 symptomatic men (mean age 64.05 ± 9.42 years) with preserved left ventricular function, scheduled for elective coronary angiography. Patients were divided and analyzed in two groups: with multivessel coronary artery disease (2-3-vessel disease, n = 46) vs. without multivessel coronary artery disease (n = 46).
Results:
Patients with multivessel CAD had significantly higher levels of hsTnT (0.01 vs. 0.007, p = 0.0021) and fasting glucose (6.0 vs. 5.45, p = 0.0112). Based on the drawn ROC curves, the cut-off points were determined for hsTnT ≥ 0.0085 ng/ml and fasting plasma glucose ≥ 5.85 mmol/l. From multivariate analysis only hsTnT in concentration higher than the cut-off point enhanced the risk of multivessel CAD (OR 4.286, 95% CI: 1.79-10.263, p = 0.001).
Conclusions:
In men with stable CAD, preserved systolic left ventricular function and non-high cardiovascular risk determined from the initial concentration of hsCRP, elevated level of hsTnT was independently associated with the risk of multivessel coronary artery disease.
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