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High-sensitivity Troponin in Predicting Coronary Artery Disease for Primary Prevention in Indian Population
Narra Lavanya1, Abraham Oomman2
1Consultant Interventional Cardiologist, Department of Cardiology, KIMS Hospital, Kondapur, Hyderabad, Telangana, India, Corresponding Author.
Insights
Elevated high-sensitivity troponin I (hs-cTnI) levels strongly correlate with coronary artery disease (CAD) detected by CT coronary angiogram. This finding supports using hs-cTnI for noninvasive CAD detection and early management.
Area of Science:
- Cardiology
- Biomarker Research
- Medical Imaging
Background:
- Cardiovascular diseases (CVDs) are a leading cause of mortality globally.
- Accurate risk assessment for coronary artery disease (CAD) is crucial for timely intervention.
- High-sensitivity troponin assays offer potential for early detection of myocardial injury.
Purpose of the Study:
- To correlate high-sensitivity troponin I (hs-cTnI) and QRISK3 cardiovascular risk score with CT coronary angiogram (CT-CAG) findings.
- To assess the accuracy of noninvasive methods for detecting or excluding CAD.
- To evaluate the utility of hs-cTnI as a biomarker for CAD.
Main Methods:
- A study of 100 patients presenting with chest pain.
- Measurement of hs-cTnI levels and calculation of QRISK3 scores.
- Performance of CT coronary angiogram (CT-CAG) to diagnose significant CAD ( >50% stenosis).
Main Results:
- No statistical correlation was found between QRISK3 scores and hs-cTnI levels.
- Elevated hs-cTnI (>6) was observed in 20% of subjects.
- A strong correlation was established between elevated hs-cTnI and the presence of CAD on CT-CAG, with 80% of subjects with elevated hs-cTnI having CAD.
Conclusions:
- Elevated hs-cTnI levels demonstrate a strong correlation with CAD diagnosed via CT-CAG.
- hs-cTnI shows promise as a noninvasive biomarker for early CAD detection.
- Early detection of CAD through biomarkers like hs-cTnI can facilitate prompt management and disease progression delay.
Objectives:
Cardiovascular diseases (CVDs) have become a major cause of mortality in India and abroad. Various risk scores have been formulated to estimate CVD risk. The preferred biomarker for the detection of myocardial cell necrosis is cardiac troponin. Highly sensitive troponin assays are now available. Computed tomography coronary angiogram (CT-CAG) is the standard noninvasive modality to identify as well as exclude coronary artery disease (CAD). Our study aims to correlate high-sensitivity troponin I (hs-cTnI) and the QRESEARCH cardiovascular (CV) risk algorithm (QRISK3) score against CT-CAG and determine whether, by using these data, we can detect or rule out CAD accurately by noninvasive means alone.
Materials And Methods:
We evaluated 100 subjects who presented with chest pain (primary prevention population) to the cardiology outpatient department. A detailed history was obtained, and blood investigations, including hs-cTnI, were conducted. The QRISK3 score was calculated, and CT-CAG was performed for all. Hs-cTnI >6 was considered significant. Those who had >50% diameter stenotic lesion(s) were deemed to have significant CAD.
Results:
In our study with 100 subjects, 80 had hs-cTnI <6, and 20 subjects had hs-cTnI >6. The QRISK3 score did not show any statistical correlation with hs-cTnI. The hs-cTnI levels were compared with CT-CAG results and found that 80% of subjects with elevated hs-cTnI had CAD.
Conclusion:
A strong correlation between elevated hs-cTnI levels and CAD by CT-CAG was established by our study. The early detection of CAD will prompt early management and delay further progression of the disease.
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