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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Cardiac biomarkers for detection of coronary artery disease in the community
Lars Lind1, Joakim Alfredsson2, Jonas S O Andersson3
1Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, SE 751 85, Sweden. lars.lind@medsci.uu.se.
Insights
Coronary artery disease burden correlates with cardiac Troponin I (TropI) levels in a large population study. This finding suggests TropI may aid in assessing atherosclerosis severity, even in individuals without prior heart disease.
Area of Science:
- Cardiology
- Biomarker Research
- Medical Imaging
Background:
- Assessing coronary artery disease (CAD) burden is crucial for cardiovascular risk stratification.
- Plasma biomarkers like Troponin I (TropI) and NT-proBNP are used in cardiac care.
- Understanding the relationship between CAD extent and these biomarkers in a general population is valuable.
Purpose of the Study:
- To determine if the extent of coronary artery disease (CAD) is associated with plasma levels of Troponin I (TropI) and NT-proBNP.
- To investigate these associations in a large, population-based cohort without prior atherosclerotic disease.
- To evaluate the potential role of TropI in improving atherosclerosis detection.
Main Methods:
- Cross-sectional study of 25,859 individuals (age 50-65) from the SCAPIS cohort.
- Coronary computed tomography (CT) angiography to assess CAD extent (Segment Involvement Score - SIS).
- Plasma measurements of TropI and NT-proBNP, with statistical adjustments for confounders.
Main Results:
- Both SIS and coronary artery calcium score were significantly associated with TropI levels (p < 0.001) in men and women.
- Proximal segments in all three coronary arteries independently correlated with TropI.
- Adding TropI to traditional risk factors offered a marginal improvement in discriminating atherosclerosis (C-statistic +0.0005, p = 0.014).
- SIS showed a weaker association with NT-proBNP, primarily in men.
Conclusions:
- The burden of coronary artery disease is significantly related to plasma TropI levels in both men and women.
- All major coronary arteries contribute to this TropI elevation.
- Plasma TropI provides a modest incremental benefit when added to traditional risk factors for detecting coronary atherosclerosis.
Abstract:
To investigate whether coronary artery disease (CAD) burden is associated with plasma levels of the myocardial biomarkers Troponin I (TropI) and NT-proBNP in a large population-based sample using a cross-sectional design. Coronary computerized tomography (CT) angiography was performed in 25,859 subjects without a history of atherosclerotic disease from SCAPIS study (age 50-65, 52% women). TropI and NT-proBNP were measured in plasma. Segment involvement score (SIS) was the primary exposure and TropI the primary outcome. Both SIS and coronary artery calcium score, were associated with TropI levels following adjustment for age, sex and multiple confounders (p < 0.001), with similar relationships in men and women. Proximal segments from all three coronary arteries were related to TropI levels independently of one another. Adding TropI to traditional risk factors marginally increased discrimination of atherosclerosis as compared to risk factors alone (C-statistics + 0.0005, p = 0.014). SIS was related also to NT-proBNP levels, mainly in men, but with lower estimates than TropI. The burden of CAD was related to TropI levels in both men and women. All three major coronary arteries contributed to this relationship. Adding TropI to traditional risk factors resulted in only marginally improved discrimination of coronary atherosclerosis.
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