Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, Dk-5000, Odense C, Denmark.
Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, Dk-5000, Odense C, Denmark.
Atherosclerosis. 2016 Feb;245:88-93. doi: 10.1016/j.atherosclerosis.2015.12.017. Epub 2015 Dec 15.
High-sensitive troponin I (hs-TnI) is an individual predictor of future cardiovascular disease (CVD). However, the relationship between hs-TnI and coronary artery calcification (CAC) as determined by computed tomography (CT) has not previously been investigated in a general population.
1173 randomized, middle-aged subjects without known CVD underwent a non-contrast cardiac-CT scan for CAC determination. Hs-TnI was detected using ARCHITECT STAT High Sensitive Troponin-I immunoassay. Total 10-year cardiovascular mortality risk was estimated using HeartScore. The relationship between hs-TnI and CAC was assessed using logistic regression analyses and receiver operating characteristic curves (ROC).
Concentrations of hs-TnI above the limit of detection were measured in 89.3% of all subjects. Presence of CAC (Agatston score >0) was detected in 29% in the lowest hs-TnI quartile compared with 55% in the highest, with a stepwise increase over the quartiles. In fully adjusted regression models with dichotomous CAC outcomes, hs-TnI was able to predict presence of CAC (OR: 1.25, 95% CI: 1.03-1.51, p = 0.025) and an Agatston score >100 (OR: 1.36, 95% CI: 1.08-1.71, p = 0.009). Subjects in the fourth hs-TnI quartile had an increased risk for presence of CAC (OR: 1.56, 95% CI: 1.06-2.26, p = 0.024) and for an Agatston score >100 (OR: 1.82, 95% CI: 1.04-3.18, p = 0.035), when compared with the first quartile. Addition of hs-TnI to HeartScore improved the ROCAUC from 0.671 to 0.695 (p < 0.0001).
Hs-TnI was associated with CAC in a Danish middle-aged population without previously known CVD. This is a step towards understanding hs-TnI as a risk marker for CVD.
高敏肌钙蛋白 I（hs-TnI）是未来心血管疾病（CVD）的个体预测因子。然而，之前尚未在一般人群中研究过 hs-TnI 与通过计算机断层扫描（CT）确定的冠状动脉钙化（CAC）之间的关系。
1173 名随机、中年、无已知 CVD 的受试者接受非对比心脏 CT 扫描以确定 CAC。hs-TnI 使用 ARCHITECT STAT 高敏肌钙蛋白-I 免疫分析法进行检测。使用 HeartScore 估计总 10 年心血管死亡率风险。使用逻辑回归分析和接收器操作特征曲线（ROC）评估 hs-TnI 与 CAC 之间的关系。
所有受试者中 89.3% 的 hs-TnI 浓度超过检测限。在最低 hs-TnI 四分位数组中，有 29% 的受试者存在 CAC（Agatston 评分>0），而在最高 hs-TnI 四分位数组中，这一比例为 55%，随着四分位数的增加而逐渐增加。在二元 CAC 结果的完全调整回归模型中，hs-TnI 能够预测 CAC 的存在（OR：1.25，95%CI：1.03-1.51，p = 0.025）和 Agatston 评分>100（OR：1.36，95%CI：1.08-1.71，p = 0.009）。第 4 个 hs-TnI 四分位数的受试者 CAC 存在的风险增加（OR：1.56，95%CI：1.06-2.26，p = 0.024）和 Agatston 评分>100 的风险增加（OR：1.82，95%CI：1.04-3.18，p = 0.035）与第 1 个四分位数相比。与 HeartScore 相比，添加 hs-TnI 可将 ROC AUC 从 0.671 提高到 0.695（p<0.0001）。
在没有先前已知 CVD 的丹麦中年人群中，hs-TnI 与 CAC 相关。这是朝着理解 hs-TnI 作为 CVD 风险标志物迈出的一步。
