Differential associations of cardiac troponin T and cardiac troponin I with coronary artery pathology and dynamics in response to short-duration exercise |
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Affiliation: | 1. Division of Medicine, Department of Cardiology, Akershus University Hospital, Lørenskog, Norway;2. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway;3. Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway;4. Division of Medicine, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway;5. Section of Cardiovascular and Renal Research Oslo University Hospital Ullevål, Oslo, Norway;1. Département de médecine, Université de Sherbrooke, Sherbrooke, QC, Canada;2. Department of Pathology and Laboratory Medicine, University of British Columbia, BC, Canada;3. Centre de recherche du CHUS, Sherbrooke, QC, Canada;1. Department of Clinical Laboratory Sciences, College of Medical Applied Sciences, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia;2. Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt;3. Chemistry Department, Faculty of Science, Damietta University, Damietta 34517, Egypt;4. Department of Laboratories, Immunology Lab, Mansoura University Children’s Hospital, Mansoura, Egypt;1. The Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China;2. The Department of Medical Administration, The First Affiliated Hospital of Harbin Medical University, Harbin, China;1. Department of Neurology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China;2. Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China;3. Department of Center of Health Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China;4. Department of Biobank, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China;5. Department of Ultrasonography, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China;1. Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, United States;2. ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, United States |
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Abstract: | BackgroundWe aimed to assess the associations between cardiac troponin (cTn) T and I concentrations, physical exercise and the presence and severity of angiographic coronary artery disease (CAD) in patients evaluated for suspected chronic coronary syndrome (CCS).Methods and resultsAll patients performed an exercise stress test on a bicycle ergometer and underwent invasive coronary angiography with weighted anatomical evaluation using the Gensini score. Blood samples were collected before and after exercise and analysed with high-sensitivity (hs) cTnT and cTnI assays.Of 297 patients (median age 62 (Quartile [Q]1–3 56–69) years, 35% female), 46% were categorized as “severe CAD” (Gensini score ≥ 20).Resting hs-cTnT and hs-cTnI concentrations were detectable in 88% and 100% of patients, with medians of 6 (Q1-3 4–9) ng/L and 1.5 (0.9–2.4) ng/L, respectively.In adjusted normalized linear regression analyses, higher resting concentrations were associated with increasing Gensini score (hs-cTnT: B 0.19, 95% Confidence Interval [CI] [0.09–0.41], p < 0.001; hs-cTnI: B 0.18, [0.06–0.30], p = 0.002).The area under the receiver operating characteristics curve for predicting severe CAD was 0.72 (95% CI [0.66–0.78]) and 0.68 (0.62–0.74) for resting hs-cTnT and hs-cTnI, p = 0.11 for difference.The median (Q1-3) relative increase in hs-cTnT and hs-cTnI concentrations were 5 (0–12) % and 13 (3–27) %, respectively, with no significant associations with CAD severity.ConclusionsIn patients with suspected CCS, higher hs-cTn concentrations at rest were associated with increasing angiographic severity of CAD, without any significant differences between the troponin isotypes. Post-exercise hs-cTn concentrations did not have discriminatory power for CAD. |
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Keywords: | Stable coronary artery disease Chronic coronary syndrome High-sensitivity Troponin Exercise testing |
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