title: High-sensitivity cardiac troponin T level is associated with angiographic complexity of coronary artery disease: a cross-sectional study.
abstract: High levels of high-sensitivity cardiac troponin T (hs-cTnT) are associated with coronary artery disease (CAD). The SYNTAX score (SXscore) is an angiographic tool used to grade the complexity and extent of CAD. We investigated the relationship between hs-cTnT levels and SXscore. We conducted a cross-sectional analysis of 408 patients who underwent first diagnostic coronary angiography between December 2011 and December 2012. SXscore was recorded, and serum hs-cTnT levels were measured in all patients. The median hs-cTnT level was 0.009 μg/L. Elevated hs-cTnT levels (≥0.014 μg/L) were observed in 136 patients (33 %). Twenty-seven patients (7 %) had complex CAD as defined by intermediate or high SXscores. The levels of hs-cTnT were significantly higher in patients with high or intermediate SXscores than in those with low SXscores (0.044 ± 0.055 vs. 0.018 ± 0.058 μg/L, p = 0.03). Multivariate analysis identified hs-cTnT level, and diabetes mellitus as independent predictors for complex CAD. The adjusted odds ratio of hs-cTnT level for predicting complex CAD was 2.86 (95 % confidence interval 1.90-4.45, p < 0.0001). Predictive value of the adjusted area under the receiver operating characteristic curve for complex CAD significantly improved after inclusion of the hs-cTnT (C statistic, 0.882 vs. 0.784). Measurement of serum hs-cTnT level has an important role in the risk stratification of patients who have a plan for diagnostic coronary angiography. In patients with clinically stable angina pectoris, slightly elevated hs-cTnT levels may indicate the presence of complex CAD.
authors.affiliation: Division of Cardiovascular Medicine, Ohashi Hospital, Toho University Medical Center, 2-17-6 Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
authors.affiliation: Division of Cardiovascular Medicine, Ohashi Hospital, Toho University Medical Center, 2-17-6 Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan. raisuke@live.jp.
authors.forename: Raisuke
authors.initials: R
authors.lastname: Iijima
authors.affiliation: Division of Cardiovascular Medicine, Ohashi Hospital, Toho University Medical Center, 2-17-6 Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Division of Cardiovascular Medicine, Ohashi Hospital, Toho University Medical Center, 2-17-6 Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sugi
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000000981:diagnostic imaging; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C545568:TNNT2 protein, human; D020107:Troponin T
keywords: Coronary artery disease; High-sensitivity cardiac troponin T; SYNTAX score