Determinants of troponin release in patients with stable coronary artery disease

• Verfasst von: Korosoglou, Grigorios [VerfasserIn]
• Verfasst von: Lehrke, Stephanie [VerfasserIn]
• Verfasst von: Mueller, Dirk [VerfasserIn]
• Verfasst von: Hosch, Waldemar P. [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Humpert, Per Magnus [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Titel: Determinants of troponin release in patients with stable coronary artery disease
• Titelzusatz: insights from CT angiography characteristics of atherosclerotic plaque
• Verf.angabe: Grigorios Korosoglou, Stephanie Lehrke, Dirk Mueller, Waldemar Hosch, Hans-Ulrich Kauczor, Per M. Humpert, Evangelos Giannitsis, Hugo A. Katus
• E-Jahr: 2011
• Jahr: April 21, 2011
• Umfang: 9 S.
• Fussnoten: Gesehen am 07.07.2022
• Titel Quelle: Enthalten in: Heart
• Ort Quelle: [London] : BMJ Publ. Group, 1996
• Jahr Quelle: 2011
• Band/Heft Quelle: 97(2011), 10, Seite 823-831
• ISSN Quelle: 1468-201X
• DOI: doi:10.1136/hrt.2010.193201
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: atherosclerosis
• Sach-SW: cardiac CT
• Sach-SW: CT scanning
• Sach-SW: High sensitive troponin T, atherosclerotic plaque
• Sach-SW: plaque composition, vascular remodeling
• K10plus-PPN: 1809430224

Abstract

Objective To understand the determinants of troponin release in patients with stable coronary artery disease (CAD) by comparing high sensitive troponin T (hsTnT) levels with computed tomography angiography (CTA) characteristics of atherosclerotic plaque. - Methods hsTnT was determined in 124 consecutive patients with stable angina, who underwent clinically indicated 256-slice CTA for suspected CAD. CTA was used to assess (1) coronary calcification; (2) stenosis severity; (3) non-calcified plaque volume; (4) plaque composition (soft or mixed, described as ‘non-calcified’ versus calcified) and (5) the presence of vascular remodeling in areas of non-calcified plaque. - Results All CT scans were performed without adverse events, and diagnostic image quality was achieved in 1830/1848 available coronary segments (99.0%). In 29/124 patients, hsTnT was ≥14 pg/ml (range 14.0-34.4). Weak, albeit significant, correlations were found between hsTnT and calcium scoring (r=0.45, p<0.001), while a stronger correlation was found between hsTnT and the total non-calcified plaque burden (r=0.79, p<0.001). Patients with non-calcified plaque (n=44) yielded significantly higher hsTnT values than those with normal vessels (n=46) or those with only calcified lesions (n=26), (12.6±5.2 vs 8.3±2.6 and 8.8±3.0 pg/ml, respectively, p<0.001). Furthermore, those with remodeled non-calcified plaque (n=8) showed even higher hsTnT values of 26.3±6.5 pg/ml than all other groups (p<0.001). This allowed the identification of patients with remodeled non-calcified plaque by hsTnT with high accuracy (area under the curve=0.90, SE=0.07, 95% CI 0.84 to 0.95). - Conclusions Chronic clinically silent rupture of non-calcified plaque with subsequent microembolisation may be a potential source of troponin elevation. In light of recent imaging studies, in which patients with positively remodeled non-calcified plaque were shown to be at high risk for developing acute coronary syndromes, hsTnT may serve as a biomarker for such ‘vulnerable’ coronary lesions even in presumably stable CAD.