title: Correlation of concentrations of high-sensitivity troponin T and high-sensitivity C-reactive protein with plaque progression as measured by CT coronary angiography.
abstract: BACKGROUND
  Elevated levels of inflammatory biomarkers are associated with increased cardiovascular morbidity and mortality.
  
  
  OBJECTIVE
  We sought to determine whether elevated concentrations of high-sensitivity troponin T (hs-TnT) and high-sensitivity C-reactive protein (hs-CRP) predict progression of coronary artery disease (CAD) as determined by coronary CT angiography (coronary CTA).
  
  
  METHODS
  Patients presenting to the emergency department with acute chest pain who initially showed no evidence of an acute coronary syndrome underwent baseline and follow-up coronary CTA (median follow-up, 23.9 months) using identical acquisition and reconstruction parameters. Coronary CTA data of each major coronary artery were co-registered. Cross-sections were assessed for the presence of calcified and noncalcified plaques. Progression of atherosclerotic plaque and change of plaque composition from noncalcified to calcified plaque was evaluated and correlated to levels of hs-TnT and hs-CRP at the time of the baseline CT.
  
  
  RESULTS
  Fifty-four patients (mean age, 54.1 years; 59% male) were included, and 6775 cross-sections were compared. CAD was detected in 12.2 ± 21.2 cross-sections per patient at baseline. Prevalence of calcified plaque increased by 1.5 ± 2.4 slices per patient (P < .0001) over the follow-up period. On average, 1.6 ± 3.6 slices with new noncalcified plaque were found per patient (P < .0001) and 0.7 ± 1.7 slices with pre-existing noncalcified plaque had progressed to calcified plaque (P < .0001). After multivariate adjustment, change of overall CAD burden was predicted by baseline hs-TnT and hs-CRP (r = 0.29; P = .039 and r = 0.40; P = .004). Change of plaque composition was associated with baseline hs-TnT (r = 0.29; P = .03).
  
  
  CONCLUSIONS
  Concentrations of hs-TnT and hs-CRP are weakly associated with a significant increase in CAD burden and change in plaque composition over 24 months independent of baseline risk factors.
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA; Department of Diagnostic and Interventional Radiology, Esslingen Hospital, Esslingen, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Seifarth
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA; Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Schlett
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA.
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Lehman
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA.
authors.forename: Fabian
authors.initials: F
authors.lastname: Bamberg
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Donnelly
authors.affiliation: Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
authors.affiliation: Department of Internal Medicine II and Cardiology, University of Ulm Medical Center, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA; Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Quynh A
authors.initials: QA
authors.lastname: Truong
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA. Electronic address: uhoffmann@partners.org.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D020107:Troponin T / Q000097:blood*; D015854:Up-Regulation; D061205:Vascular Calcification / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology
chemical_list: D015415:Biomarkers; C545568:TNNT2 protein, human; D020107:Troponin T; D002097:C-Reactive Protein
keywords: Cardiac biomarker; Coronary CT angiography; Coronary artery disease; Coronary atherosclerotic plaque; Plaque progression