Unstable coronary plaque characteristics are associated with high-sensitivity cardiac troponin T and N-terminal Pro-Brain Natriuretic Peptide.
BACKGROUND
Unstable plaque characteristics on coronary CT angiography (CTA), serum high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal Pro-Brain Natriuretic Peptide (NT-proBNP) concentrations are associated with cardiovascular events.


OBJECTIVE
To investigate the association between coronary CTA defined quantifiable plaque characteristics, hs-cTnT and NT-proBNP.


METHODS
81 consecutive stable chest pain patients with an intermediate-to-high risk were analyzed. Coronary CTA was performed using a 64-slice multidetector-row CT-scanner. Total coronary plaque volume, calcified volume, non-calcified volume, plaque burden, remodeling index (RI) and number of plaques were measured using dedicated software. A total plaque score ("Sum plaque score") incorporating total plaque volume, RI, plaque burden and number of plaques was defined. Hs-cTnT and NT-proBNP concentrations were measured in serum samples before coronary CTA.


RESULTS
Univariate regression analysis demonstrated significant associations of hs-cTnT and NT-proBNP with total plaque volume (r hs-cTnT = .256; r NT-proBNP = .270), calcified volume (r hs-cTnT = .344; r NT-proBNP = .344), RI (r hs-cTnT = .335; r NT-proBNP = .342) and number of plaques (r hs-cTnT = .355; r NT-proBNP = .301) (all P values ≤ .021). Non-calcified plaque volume showed no association with hs-cTnT and NT-proBNP (r hs-cTnT = .050; r NT-proBNP = .087; P value = .660 and P value = .442). The "Sum plaque score" showed the highest correlation compared to other plaque parameters (r hs-cTnT = .362; r NT-proBNP = .409; P value = .001 and P value ≤ .001).


CONCLUSIONS
Our data suggest that coronary plaque morphology parameters, derived by dedicated software, are associated with serum hs-cTnT and NT-proBNP concentrations.
Department of Cardiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; Cardiovascular Research Institute, School for Cardiovascular Diseases, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Sibel
S
Altintas
Central Diagnostic Laboratory, Department of Clinical Chemistry, MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Eline P M
EP
Cardinaels
Department of Cardiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Mathijs O
MO
Versteylen
Department of Cardiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Ivo A
IA
Joosen
Department of Cardiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Milan
M
Seifert
Cardiovascular Research Institute, School for Cardiovascular Diseases, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; Department of Radiology, MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Joachim E
JE
Wildberger
Department of Cardiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; Cardiovascular Research Institute, School for Cardiovascular Diseases, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Harry J
HJ
Crijns
Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Faculty of Health, Medicine and Life Sciences, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Patricia J
PJ
Nelemans
Central Diagnostic Laboratory, Department of Clinical Chemistry, MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Marja P
MP
Van Dieijen-Visser
Cardiovascular Research Institute, School for Cardiovascular Diseases, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; Central Diagnostic Laboratory, Department of Clinical Chemistry, MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Alma M A
AM
Mingels
Cardiovascular Research Institute, School for Cardiovascular Diseases, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; Department of Radiology, MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Marco
M
Das
Department of Cardiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; Cardiovascular Research Institute, School for Cardiovascular Diseases, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; Department of Radiology, MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. Electronic address: b.kietselaer@mumc.nl.
Bas L
BL
Kietselaer
D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D020107:Troponin T; D020097:Natriuretic Peptide, Brain
Biological markers; Cardiac troponin; Coronary CT angiography; Coronary plaque; Natriuretic peptide; Plaque burden; Plaque quantification; Plaque volume; Quantitative coronary tree analysis