不稳定冠状动脉斑块特征与高敏心肌肌钙蛋白T及N末端B型利钠肽原相关。
Unstable coronary plaque characteristics are associated with high-sensitivity cardiac troponin T and N-terminal Pro-Brain Natriuretic Peptide.
作者信息
Altintas Sibel, Cardinaels Eline P M, Versteylen Mathijs O, Joosen Ivo A, Seifert Milan, Wildberger Joachim E, Crijns Harry J, Nelemans Patricia J, Van Dieijen-Visser Marja P, Mingels Alma M A, Das Marco, Kietselaer Bas L
机构信息
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.
Central Diagnostic Laboratory, Department of Clinical Chemistry, MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
出版信息
J Cardiovasc Comput Tomogr. 2016 Jan-Feb;10(1):82-8. doi: 10.1016/j.jcct.2015.10.001. Epub 2015 Oct 10.
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).
CONCLUSION
Our data suggest that coronary plaque morphology parameters, derived by dedicated software, are associated with serum hs-cTnT and NT-proBNP concentrations.
背景
冠状动脉CT血管造影（CTA）显示的不稳定斑块特征、血清高敏心肌肌钙蛋白T（hs-cTnT）和N末端脑钠肽前体（NT-proBNP）浓度与心血管事件相关。
目的
研究冠状动脉CTA定义的可量化斑块特征、hs-cTnT和NT-proBNP之间的关联。
方法
对81例连续的中高危稳定型胸痛患者进行分析。使用64层多排螺旋CT扫描仪进行冠状动脉CTA检查。使用专用软件测量冠状动脉总斑块体积、钙化体积、非钙化体积、斑块负荷、重构指数（RI）和斑块数量。定义了一个综合总斑块体积、RI、斑块负荷和斑块数量的总斑块评分（“总斑块评分”）。在冠状动脉CTA检查前，检测血清样本中的hs-cTnT和NT-proBNP浓度。
结果
单因素回归分析显示，hs-cTnT和NT-proBNP与总斑块体积（r hs-cTnT = 0.256；r NT-proBNP = 0.270）、钙化体积（r hs-cTnT = 0.344；r NT-proBNP = 0.344）、RI（r hs-cTnT = 0.335；r NT-proBNP = 0.342）和斑块数量（r hs-cTnT = 0.355；r NT-proBNP = 0.301）均存在显著相关性（所有P值≤0.021）。非钙化斑块体积与hs-cTnT和NT-proBNP无相关性（r hs-cTnT = 0.050；r NT-proBNP = 0.087；P值 = 0.660和P值 = 0.442）。与其他斑块参数相比，“总斑块评分”的相关性最高（r hs-cTnT = 0.362；r NT-proBNP = 0.409；P值 = 0.001和P值≤0.001）。
结论
我们的数据表明，由专用软件得出的冠状动脉斑块形态学参数与血清hs-cTnT和NT-proBNP浓度相关。
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