Yamazaki Kenji, Iijima Raisuke, Nakamura Masato, Sugi Kaoru
Division of Cardiovascular Medicine, Ohashi Hospital, Toho University Medical Center, 2-17-6 Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan.
Heart Vessels. 2016 Jun;31(6):890-6. doi: 10.1007/s00380-015-0689-6. Epub 2015 May 12.
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.
高敏心肌肌钙蛋白T（hs-cTnT）水平升高与冠状动脉疾病（CAD）相关。SYNTAX评分（SXscore）是一种用于评估CAD复杂性和范围的血管造影工具。我们研究了hs-cTnT水平与SXscore之间的关系。我们对2011年12月至2012年12月期间接受首次诊断性冠状动脉造影的408例患者进行了横断面分析。记录SXscore，并测量所有患者的血清hs-cTnT水平。hs-cTnT水平中位数为0.009μg/L。136例患者（33%）hs-cTnT水平升高（≥0.014μg/L）。27例患者（7%）患有根据中度或高度SXscore定义的复杂CAD。高度或中度SXscore患者的hs-cTnT水平显著高于低度SXscore患者（0.044±0.055 vs. 0.018±0.058μg/L，p = 0.03）。多变量分析确定hs-cTnT水平和糖尿病是复杂CAD的独立预测因素。hs-cTnT水平预测复杂CAD的调整后比值比为2.86（95%置信区间1.90 - 4.45，p < 0.0001）。纳入hs-cTnT后，复杂CAD的调整后受试者工作特征曲线下面积的预测价值显著提高（C统计量，0.882 vs. 0.784）。血清hs-cTnT水平的测量在计划进行诊断性冠状动脉造影的患者风险分层中具有重要作用。在临床稳定型心绞痛患者中，hs-cTnT水平轻度升高可能表明存在复杂CAD。
