Usefulness of High Sensitivity Cardiac Troponin T for the Identification of Outlier Patients with Diffuse Coronary Atherosclerosis and Low Risk Factors
Abstract Novel high sensitivity assay can detect very low levels of circulating cardiac troponin (hs-cTnT) in apparently healthy individuals. Within normal range, higher levels are associated with coronary atherosclerotic disease (CAD) and cardiac abnormalities commonly associated to traditional ris...
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| Veröffentlicht in: | The American journal of cardiology 2016-05, Vol.117 (9), p.1397-1404 |
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| creator | Magnoni, Marco, MD Masson, Serge, PhD Andreini, Daniele, MD Moccetti, Tiziano, MD Modena, Maria Grazia, MD Canestrari, Mauro, MD Berti, Sergio, MD Casolo, Giancarlo, MD Gabrielli, Domenico, MD Marraccini, Paolo, MD Pontone, Gianluca, MD Latini, Roberto, MD Maggioni, Aldo Pietro, MD Maseri, Attilio, MD |
| description | Abstract Novel high sensitivity assay can detect very low levels of circulating cardiac troponin (hs-cTnT) in apparently healthy individuals. Within normal range, higher levels are associated with coronary atherosclerotic disease (CAD) and cardiac abnormalities commonly associated to traditional risk factors (RFs) for CAD. Therefore, we investigated the relation between circulating hs-cTnT and CAD in patients with a spectrum of RF burden aiming to assess the added value of hs-cTnT to identify outlier patients with CAD in spite of a low RF burden. H s-cTnT was measured in 525 stable patients without previous diagnosis of IHD with 0-1 RF, excluded diabetes, (Low-RF group, n=263) or ≥2 RFs (Multiple-RF group, n=262) and without CAD (segment involvement score, SIS=0) or diffuse CAD (SIS>5) at coronary computed tomography angiography. Outlier patients with diffuse CAD in spite of low RF burden had similar extent, severity and plaque composition than patients with multiple RFs. Overall, hs-cTnT was measurable in 81% of patients with median value of 6.0 ng/L. In both groups, hs-cTnT concentration was higher in patients with CAD than in patients with normal coronary arteries (p6 ng/L) was independently associated with CAD in low-RF group only. D espite very low circulating concentrations, hs-cTnT may identify with a good accuracy the outlier patients with diffuse coronary atherosclerotic disease in spite of low RF burden. |
| doi_str_mv | 10.1016/j.amjcard.2016.02.002 |
| format | Article |
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Within normal range, higher levels are associated with coronary atherosclerotic disease (CAD) and cardiac abnormalities commonly associated to traditional risk factors (RFs) for CAD. Therefore, we investigated the relation between circulating hs-cTnT and CAD in patients with a spectrum of RF burden aiming to assess the added value of hs-cTnT to identify outlier patients with CAD in spite of a low RF burden. H s-cTnT was measured in 525 stable patients without previous diagnosis of IHD with 0-1 RF, excluded diabetes, (Low-RF group, n=263) or ≥2 RFs (Multiple-RF group, n=262) and without CAD (segment involvement score, SIS=0) or diffuse CAD (SIS>5) at coronary computed tomography angiography. Outlier patients with diffuse CAD in spite of low RF burden had similar extent, severity and plaque composition than patients with multiple RFs. Overall, hs-cTnT was measurable in 81% of patients with median value of 6.0 ng/L. In both groups, hs-cTnT concentration was higher in patients with CAD than in patients with normal coronary arteries (p<0.0001). Hs-cTnT was more accurate to detect patients with CAD in the Low-RF group than in the Multiple-RF group (p=0.04). In multivariate analysis, higher level of hs-cTnT (>6 ng/L) was independently associated with CAD in low-RF group only. D espite very low circulating concentrations, hs-cTnT may identify with a good accuracy the outlier patients with diffuse coronary atherosclerotic disease in spite of low RF burden.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2016.02.002</identifier><identifier>PMID: 26976791</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute coronary syndromes ; Aged ; Anxiety ; Atherosclerosis ; Automation ; Biomarkers - blood ; Body Mass Index ; Cardiomyopathy ; Cardiovascular ; Cardiovascular disease ; Cholesterol ; Cholesterol - blood ; Confidence intervals ; Coronary Artery Disease - blood ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - etiology ; Coronary vessels ; Creatinine - blood ; Cross-Sectional Studies ; Diabetes ; Family medical history ; Female ; Heart attacks ; Hospitals ; Humans ; Hypertension ; Laboratories ; Lipoproteins ; Male ; Methods ; Middle Aged ; Predictive Value of Tests ; Regression Analysis ; Risk Factors ; Troponin T - blood ; Values</subject><ispartof>The American journal of cardiology, 2016-05, Vol.117 (9), p.1397-1404</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited May 1, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-b7c320d3b530944750e52f20467230ba59528b329b8ca3aae1b5392fc45b947d3</citedby><cites>FETCH-LOGICAL-c481t-b7c320d3b530944750e52f20467230ba59528b329b8ca3aae1b5392fc45b947d3</cites><orcidid>0000-0003-3094-9391 ; 0000-0003-3392-0527 ; 0000-0002-1446-0281</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914916302156$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26976791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Magnoni, Marco, MD</creatorcontrib><creatorcontrib>Masson, Serge, PhD</creatorcontrib><creatorcontrib>Andreini, Daniele, MD</creatorcontrib><creatorcontrib>Moccetti, Tiziano, MD</creatorcontrib><creatorcontrib>Modena, Maria Grazia, MD</creatorcontrib><creatorcontrib>Canestrari, Mauro, MD</creatorcontrib><creatorcontrib>Berti, Sergio, MD</creatorcontrib><creatorcontrib>Casolo, Giancarlo, MD</creatorcontrib><creatorcontrib>Gabrielli, Domenico, MD</creatorcontrib><creatorcontrib>Marraccini, Paolo, MD</creatorcontrib><creatorcontrib>Pontone, Gianluca, MD</creatorcontrib><creatorcontrib>Latini, Roberto, MD</creatorcontrib><creatorcontrib>Maggioni, Aldo Pietro, MD</creatorcontrib><creatorcontrib>Maseri, Attilio, MD</creatorcontrib><creatorcontrib>CAPIRE Study Group</creatorcontrib><title>Usefulness of High Sensitivity Cardiac Troponin T for the Identification of Outlier Patients with Diffuse Coronary Atherosclerosis and Low Risk Factors</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Abstract Novel high sensitivity assay can detect very low levels of circulating cardiac troponin (hs-cTnT) in apparently healthy individuals. Within normal range, higher levels are associated with coronary atherosclerotic disease (CAD) and cardiac abnormalities commonly associated to traditional risk factors (RFs) for CAD. Therefore, we investigated the relation between circulating hs-cTnT and CAD in patients with a spectrum of RF burden aiming to assess the added value of hs-cTnT to identify outlier patients with CAD in spite of a low RF burden. H s-cTnT was measured in 525 stable patients without previous diagnosis of IHD with 0-1 RF, excluded diabetes, (Low-RF group, n=263) or ≥2 RFs (Multiple-RF group, n=262) and without CAD (segment involvement score, SIS=0) or diffuse CAD (SIS>5) at coronary computed tomography angiography. Outlier patients with diffuse CAD in spite of low RF burden had similar extent, severity and plaque composition than patients with multiple RFs. Overall, hs-cTnT was measurable in 81% of patients with median value of 6.0 ng/L. In both groups, hs-cTnT concentration was higher in patients with CAD than in patients with normal coronary arteries (p<0.0001). Hs-cTnT was more accurate to detect patients with CAD in the Low-RF group than in the Multiple-RF group (p=0.04). In multivariate analysis, higher level of hs-cTnT (>6 ng/L) was independently associated with CAD in low-RF group only. D espite very low circulating concentrations, hs-cTnT may identify with a good accuracy the outlier patients with diffuse coronary atherosclerotic disease in spite of low RF burden.</description><subject>Acute coronary syndromes</subject><subject>Aged</subject><subject>Anxiety</subject><subject>Atherosclerosis</subject><subject>Automation</subject><subject>Biomarkers - blood</subject><subject>Body Mass Index</subject><subject>Cardiomyopathy</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Cholesterol - blood</subject><subject>Confidence intervals</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - etiology</subject><subject>Coronary vessels</subject><subject>Creatinine - blood</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Family medical history</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Laboratories</subject><subject>Lipoproteins</subject><subject>Male</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Troponin T - 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Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Magnoni, Marco, MD</au><au>Masson, Serge, PhD</au><au>Andreini, Daniele, MD</au><au>Moccetti, Tiziano, MD</au><au>Modena, Maria Grazia, MD</au><au>Canestrari, Mauro, MD</au><au>Berti, Sergio, MD</au><au>Casolo, Giancarlo, MD</au><au>Gabrielli, Domenico, MD</au><au>Marraccini, Paolo, MD</au><au>Pontone, Gianluca, MD</au><au>Latini, Roberto, MD</au><au>Maggioni, Aldo Pietro, MD</au><au>Maseri, Attilio, MD</au><aucorp>CAPIRE Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of High Sensitivity Cardiac Troponin T for the Identification of Outlier Patients with Diffuse Coronary Atherosclerosis and Low Risk Factors</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>117</volume><issue>9</issue><spage>1397</spage><epage>1404</epage><pages>1397-1404</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Abstract Novel high sensitivity assay can detect very low levels of circulating cardiac troponin (hs-cTnT) in apparently healthy individuals. Within normal range, higher levels are associated with coronary atherosclerotic disease (CAD) and cardiac abnormalities commonly associated to traditional risk factors (RFs) for CAD. Therefore, we investigated the relation between circulating hs-cTnT and CAD in patients with a spectrum of RF burden aiming to assess the added value of hs-cTnT to identify outlier patients with CAD in spite of a low RF burden. H s-cTnT was measured in 525 stable patients without previous diagnosis of IHD with 0-1 RF, excluded diabetes, (Low-RF group, n=263) or ≥2 RFs (Multiple-RF group, n=262) and without CAD (segment involvement score, SIS=0) or diffuse CAD (SIS>5) at coronary computed tomography angiography. Outlier patients with diffuse CAD in spite of low RF burden had similar extent, severity and plaque composition than patients with multiple RFs. Overall, hs-cTnT was measurable in 81% of patients with median value of 6.0 ng/L. In both groups, hs-cTnT concentration was higher in patients with CAD than in patients with normal coronary arteries (p<0.0001). Hs-cTnT was more accurate to detect patients with CAD in the Low-RF group than in the Multiple-RF group (p=0.04). In multivariate analysis, higher level of hs-cTnT (>6 ng/L) was independently associated with CAD in low-RF group only. D espite very low circulating concentrations, hs-cTnT may identify with a good accuracy the outlier patients with diffuse coronary atherosclerotic disease in spite of low RF burden.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26976791</pmid><doi>10.1016/j.amjcard.2016.02.002</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3094-9391</orcidid><orcidid>https://orcid.org/0000-0003-3392-0527</orcidid><orcidid>https://orcid.org/0000-0002-1446-0281</orcidid></addata></record> |
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| ispartof | The American journal of cardiology, 2016-05, Vol.117 (9), p.1397-1404 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acute coronary syndromes Aged Anxiety Atherosclerosis Automation Biomarkers - blood Body Mass Index Cardiomyopathy Cardiovascular Cardiovascular disease Cholesterol Cholesterol - blood Confidence intervals Coronary Artery Disease - blood Coronary Artery Disease - diagnosis Coronary Artery Disease - etiology Coronary vessels Creatinine - blood Cross-Sectional Studies Diabetes Family medical history Female Heart attacks Hospitals Humans Hypertension Laboratories Lipoproteins Male Methods Middle Aged Predictive Value of Tests Regression Analysis Risk Factors Troponin T - blood Values |
| title | Usefulness of High Sensitivity Cardiac Troponin T for the Identification of Outlier Patients with Diffuse Coronary Atherosclerosis and Low Risk Factors |
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