Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease

Gitte Pedersen; Jonathan Nørtoft Dahl; Laust Dupont Rasmussen; Anne-Birgitte Garm Blavnsfeldt; Sidsel Hauge Böttcher; Matias Hauge Böttcher; Mette Nyegaard; Louise Nissen; Simon Winther

doi:10.1016/j.jcct.2024.06.009

Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease

Gitte Pedersen^*, Jonathan Nørtoft Dahl, Laust Dupont Rasmussen, Anne-Birgitte Garm Blavnsfeldt, Sidsel Hauge Böttcher, Matias Hauge Böttcher, Mette Nyegaard, Louise Nissen, Simon Winther

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

4 Citations (Scopus)

Abstract

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

Original language	English
Journal	Journal of Cardiovascular Computed Tomography
Volume	18
Issue	5
Pages (from-to)	467-475
Number of pages	9
ISSN	1934-5925
DOIs	https://doi.org/10.1016/j.jcct.2024.06.009
Publication status	Published - 2024

Keywords

C-reactive protein
Coronary artery disease
Coronary stenosis
High-risk plaques
Pre-test probability
Troponin I

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Pedersen, G., Dahl, J. N., Rasmussen, L. D., Garm Blavnsfeldt, A.-B., Böttcher, S. H., Böttcher, M. H., Nyegaard, M., Nissen, L., & Winther, S. (2024). Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease. Journal of Cardiovascular Computed Tomography, 18(5), 467-475. https://doi.org/10.1016/j.jcct.2024.06.009

@article{49f92aef878e4e0eb010d3f4e196ef85,

title = "Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease",

abstract = "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",

keywords = "C-reactive protein, Coronary artery disease, Coronary stenosis, High-risk plaques, Pre-test probability, Troponin I",

author = "Gitte Pedersen and Dahl, {Jonathan N{\o}rtoft} and Rasmussen, {Laust Dupont} and {Garm Blavnsfeldt}, Anne-Birgitte and B{\"o}ttcher, {Sidsel Hauge} and B{\"o}ttcher, {Matias Hauge} and Mette Nyegaard and Louise Nissen and Simon Winther",

year = "2024",

doi = "10.1016/j.jcct.2024.06.009",

language = "English",

volume = "18",

pages = "467--475",

journal = "Journal of Cardiovascular Computed Tomography",

issn = "1934-5925",

publisher = "Elsevier Inc.",

number = "5",

}

Pedersen, G, Dahl, JN , Rasmussen, LD, Garm Blavnsfeldt, A-B, Böttcher, SH, Böttcher, MH, Nyegaard, M, Nissen, L & Winther, S 2024, 'Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease', Journal of Cardiovascular Computed Tomography, vol. 18, no. 5, pp. 467-475. https://doi.org/10.1016/j.jcct.2024.06.009

Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease. / Pedersen, Gitte; Dahl, Jonathan Nørtoft ; Rasmussen, Laust Dupont et al.
In: Journal of Cardiovascular Computed Tomography, Vol. 18, No. 5, 2024, p. 467-475.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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 -

Biomarkers for identification of high-risk coronary artery plaques in patients with suspected coronary artery disease

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