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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Association between high-sensitive troponin I and coronary artery calcification in a Danish general population
Fredrik Olson1, Jonathan Engborg1, Mette H Grønhøj1
1Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, Dk-5000, Odense C, Denmark.
Insights
High-sensitive troponin I (hs-TnI) is linked to coronary artery calcification (CAC) in middle-aged individuals without known cardiovascular disease (CVD). This finding suggests hs-TnI may help identify individuals at higher risk for developing CVD.
Area of Science:
- Cardiology
- Biomarkers
- Medical Imaging
Background:
- High-sensitive troponin I (hs-TnI) is a known predictor of future cardiovascular disease (CVD).
- The association between hs-TnI and coronary artery calcification (CAC) in the general population has not been previously studied.
Purpose of the Study:
- To investigate the relationship between hs-TnI levels and the presence and severity of CAC.
- To evaluate hs-TnI as a potential risk marker for subclinical atherosclerosis.
Main Methods:
- 1173 middle-aged subjects without known CVD underwent cardiac computed tomography (CT) for CAC assessment.
- Hs-TnI levels were measured using a high-sensitivity immunoassay.
- Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the association between hs-TnI and CAC.
Main Results:
- Hs-TnI was detected in 89.3% of subjects.
- Higher hs-TnI quartiles were associated with a stepwise increase in CAC prevalence (29% in the lowest vs. 55% in the highest quartile).
- Hs-TnI independently predicted the presence of CAC (OR: 1.25) and high Agatston scores (OR: 1.36), and improved risk prediction when added to the HeartScore (ROCAUC increased from 0.671 to 0.695).
Conclusions:
- Hs-TnI is associated with subclinical coronary atherosclerosis (CAC) in a middle-aged population without diagnosed CVD.
- This study supports hs-TnI's role as a valuable biomarker for assessing cardiovascular risk.
Background:
High-sensitive troponin I (hs-TnI) is an individual predictor of future cardiovascular disease (CVD). However, the relationship between hs-TnI and coronary artery calcification (CAC) as determined by computed tomography (CT) has not previously been investigated in a general population.
Methods:
1173 randomized, middle-aged subjects without known CVD underwent a non-contrast cardiac-CT scan for CAC determination. Hs-TnI was detected using ARCHITECT STAT High Sensitive Troponin-I immunoassay. Total 10-year cardiovascular mortality risk was estimated using HeartScore. The relationship between hs-TnI and CAC was assessed using logistic regression analyses and receiver operating characteristic curves (ROC).
Results:
Concentrations of hs-TnI above the limit of detection were measured in 89.3% of all subjects. Presence of CAC (Agatston score >0) was detected in 29% in the lowest hs-TnI quartile compared with 55% in the highest, with a stepwise increase over the quartiles. In fully adjusted regression models with dichotomous CAC outcomes, hs-TnI was able to predict presence of CAC (OR: 1.25, 95% CI: 1.03-1.51, p = 0.025) and an Agatston score >100 (OR: 1.36, 95% CI: 1.08-1.71, p = 0.009). Subjects in the fourth hs-TnI quartile had an increased risk for presence of CAC (OR: 1.56, 95% CI: 1.06-2.26, p = 0.024) and for an Agatston score >100 (OR: 1.82, 95% CI: 1.04-3.18, p = 0.035), when compared with the first quartile. Addition of hs-TnI to HeartScore improved the ROCAUC from 0.671 to 0.695 (p < 0.0001).
Conclusion:
Hs-TnI was associated with CAC in a Danish middle-aged population without previously known CVD. This is a step towards understanding hs-TnI as a risk marker for CVD.
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