TY - JOUR
T1 - Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease
AU - Pedersen, Gitte
AU - Dahl, Jonathan Nørtoft
AU - Rasmussen, Laust Dupont
AU - Garm Blavnsfeldt, Anne-Birgitte
AU - Böttcher, Sidsel Hauge
AU - Böttcher, Matias Hauge
AU - Nyegaard, Mette
AU - Nissen, Louise
AU - Winther, Simon
PY - 2024
Y1 - 2024
N2 - Background: Patients with atherosclerotic plaques containing high-risk features have an increased likelihood of events and a worse prognosis. Whether increased levels of Troponin I (TnI) and C-reactive protein (CRP) are associated with the presence of high-risk coronary atherosclerotic plaques (HRP) is not well described. We assessed the association between 1) TnI and 2) CRP with quantified coronary plaque burden, luminal diameter stenosis, and HRP in patients with low/intermediate pre-test probability of obstructive coronary artery disease (CAD) referred for coronary computed tomography angiography (CCTA). Methods: The CCTA from 1615 patients were analyzed using a semiautomatic software for coronary artery plaque characterization. Patients with high TnI (>6 ng/L) and high CRP (>2 mg/L) were identified. Associations of TnI and CRP with plaque burden, stenosis (≥50% luminal diameter stenosis on CCTA), and HRP were investigated. Results: TnI and CRP were both positively correlated with total plaque burden (TnI rs = 0.14, p < 0.001; CRP rs = 0.08, p < 0.001). In multivariate logistic regression analyses, high TnI was associated with stenosis (OR 1.43, 95% confidence interval (CI) 1.03–1.99, p = 0.034), the presence of HRP (OR 1.79, 95% CI: 1.17–2.74, p = 0.008), and the subtypes of HRP; low attenuation plaque (OR 1.93, 95% CI: 1.24–3.00, p = 0.003), and positive remodeling (OR 1.51, 95% CI: 1.07–2.13, p = 0.018). For CRP, only stenosis and napkin ring sign correlated significantly. Conclusion: In patients with suspected CAD, TnI and CRP are associated with HRP features. These findings may suggest that inflammatory and particularly ischemic biomarkers might improve early risk stratification and affect patient management.NCT02264717
AB - Background: Patients with atherosclerotic plaques containing high-risk features have an increased likelihood of events and a worse prognosis. Whether increased levels of Troponin I (TnI) and C-reactive protein (CRP) are associated with the presence of high-risk coronary atherosclerotic plaques (HRP) is not well described. We assessed the association between 1) TnI and 2) CRP with quantified coronary plaque burden, luminal diameter stenosis, and HRP in patients with low/intermediate pre-test probability of obstructive coronary artery disease (CAD) referred for coronary computed tomography angiography (CCTA). Methods: The CCTA from 1615 patients were analyzed using a semiautomatic software for coronary artery plaque characterization. Patients with high TnI (>6 ng/L) and high CRP (>2 mg/L) were identified. Associations of TnI and CRP with plaque burden, stenosis (≥50% luminal diameter stenosis on CCTA), and HRP were investigated. Results: TnI and CRP were both positively correlated with total plaque burden (TnI rs = 0.14, p < 0.001; CRP rs = 0.08, p < 0.001). In multivariate logistic regression analyses, high TnI was associated with stenosis (OR 1.43, 95% confidence interval (CI) 1.03–1.99, p = 0.034), the presence of HRP (OR 1.79, 95% CI: 1.17–2.74, p = 0.008), and the subtypes of HRP; low attenuation plaque (OR 1.93, 95% CI: 1.24–3.00, p = 0.003), and positive remodeling (OR 1.51, 95% CI: 1.07–2.13, p = 0.018). For CRP, only stenosis and napkin ring sign correlated significantly. Conclusion: In patients with suspected CAD, TnI and CRP are associated with HRP features. These findings may suggest that inflammatory and particularly ischemic biomarkers might improve early risk stratification and affect patient management.NCT02264717
KW - C-reactive protein
KW - Coronary artery disease
KW - Coronary stenosis
KW - High-risk plaques
KW - Pre-test probability
KW - Troponin I
UR - http://www.scopus.com/inward/record.url?scp=85197054435&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2024.06.009
DO - 10.1016/j.jcct.2024.06.009
M3 - Journal article
C2 - 38955554
AN - SCOPUS:85197054435
SN - 1934-5925
VL - 18
SP - 467
EP - 475
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
IS - 5
ER -