High Sensitivity Troponins Discriminate Different Morphologies of Coronary Artery Plaques Being Assessed by Coronary...

Area of Science:

• Cardiology
• Biomarkers
• Medical Imaging

Background:

• Coronary artery disease (CAD) diagnosis relies on assessing coronary artery plaque morphology.
• High-sensitivity troponin assays (hsTnI and hsTnT) are increasingly used in cardiovascular risk assessment.
• The relationship between troponin levels and specific coronary plaque characteristics remains an area of investigation.

Purpose of the Study:

• To evaluate the association between high sensitivity troponin I (hsTnI) and T (hsTnT) levels and coronary plaque morphology.
• To determine if hsTnI and hsTnT can differentiate between various coronary plaque types detected by coronary computed tomography angiography (CCTA).
• To identify which troponin assay, if any, is independently associated with specific plaque morphologies.

Main Methods:

• Prospective enrollment of 99 patients with suspected CAD undergoing CCTA.
• Measurement of hsTnI, hsTnT, and NT-proBNP from blood samples collected within 24 hours of CCTA.
• Analysis of coronary plaque morphology (noncalcified, calcified, mixed) using CCTA findings.
• Statistical analysis including discrimination analysis and multivariate logistic regression.

Main Results:

• A total of 99 patients were analyzed, with plaque types including noncalcified (9%), calcified (28%), and mixed (19%).
• Both hsTnI and hsTnT demonstrated significant ability to discriminate between different plaque morphologies (AUC 0.741-0.752, p=0.0001).
• Multivariate analysis revealed hsTnT, but not hsTnI, was significantly associated with mixed coronary plaques (OR=8.968, p=0.004).

Conclusions:

• Both hsTnI and hsTnT are valuable biomarkers for differentiating coronary plaque morphologies.
• hsTnT shows a significant independent association with mixed coronary plaques in patients with suspected CAD.
• These findings suggest a potential role for hsTnT in characterizing plaque vulnerability.