高敏心肌肌钙蛋白I和T与以阿加斯顿评分表示的冠状动脉计算机断层扫描评估的钙评分之间关联的比较分析。
Comparative analysis of high-sensitivity cardiac troponin I and T for their association with coronary computed tomography-assessed calcium scoring represented by the Agatston score.
作者信息
Rusnak Jonas, Behnes Michael, Henzler Thomas, Reckord Nadine, Vogler Nils, Meyer Mathias, Hoffmann Ursula, Natale Michele, Hoffmann Julia, Hamed Sonja, Weidner Kathrin, Lang Siegfried, Mukherji Agnibh, Haubenreisser Holger, Schoenberg Stefan O, Borggrefe Martin, Bertsch Thomas, Akin Ibrahim
机构信息
First Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
DZHK (German Center for Cardiovascular Research) Partner Site Mannheim, Mannheim, Germany.
出版信息
Eur J Med Res. 2017 Nov 16;22(1):47. doi: 10.1186/s40001-017-0290-9.
BACKGROUND
This study evaluates the association between high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT) and coronary calcium concentration (CAC) detected by coronary computed tomography (CCT) and evaluated with the Agatston score in patients with suspected coronary artery disease (CAD).
METHODS
Patients undergoing CCT during routine clinical care were enrolled prospectively. CCT was indicated for patients with a low to intermediate pretest probability for CAD. Within 24 h of CCT examination, peripheral blood samples were taken to measure cardiac biomarkers hs-cTnI and hs-cTnT.
RESULTS
A total of 76 patients were enrolled including 38% without detectable CAC, 36% with an Agatston score from 1 to 100, 17% from 101 to 400, and 9% with values ≥ 400. hs-cTnI was increasing alongside Agatston score and was able to differentiate between different groups of Agatston scores. Both hs-cTn discriminated values greater than 100 (hs-cTnI, AUC = 0.663; p = 0.032; hs-cTnT, AUC = 0.650; p = 0.048). In univariate and multivariate logistic regression models, hs-cTnT and hs-cTnI were significantly associated with increased Agatston scores. Patients with hs-cTnT ≥ 0.02 µg/l and hs-cTnI ≥ 5.5 ng/l were more likely to reveal values ≥ 400 (hs-cTnT; OR = 13.4; 95% CI 1.545-116.233; p = 0.019; hs-cTnI; OR = 8.8; 95% CI 1.183-65.475; p = 0.034).
CONCLUSION
The present study shows that the Agatston score was significantly correlated with hs cardiac troponins, both in univariable and multivariable linear regression models. Hs-cTnI is able to discriminate between different Agatston values. The present results might reveal potential cut-off values for hs cardiac troponins regarding different Agatston values. Trial registration Cardiovascular Imaging and Biomarker Analyses (CIBER), NCT03074253 https://clinicaltrials.gov/ct2/show/record/NCT03074253.
背景
本研究评估了高敏心肌肌钙蛋白I（hs-cTnI）和T（hs-cTnT）与冠状动脉计算机断层扫描（CCT）检测到的冠状动脉钙浓度（CAC）之间的关联，并采用阿加斯顿评分对疑似冠状动脉疾病（CAD）患者进行评估。
方法
前瞻性纳入在常规临床护理期间接受CCT检查的患者。CCT适用于CAD预测概率低至中等的患者。在CCT检查后24小时内采集外周血样本，以测量心脏生物标志物hs-cTnI和hs-cTnT。
结果
共纳入76例患者，其中38%未检测到CAC，36%的阿加斯顿评分为1至100，17%为101至400，9%的值≥400。hs-cTnI随着阿加斯顿评分的增加而升高，并且能够区分不同阿加斯顿评分组。两种hs-cTn均能区分大于100的值（hs-cTnI，AUC = 0.663；p = 0.032；hs-cTnT，AUC = 0.650；p = 0.048）。在单变量和多变量逻辑回归模型中，hs-cTnT和hs-cTnI与阿加斯顿评分增加显著相关。hs-cTnT≥0.02µg/l且hs-cTnI≥5.5ng/l的患者更有可能显示值≥400（hs-cTnT；OR = 13.4；95%CI 1.545 - 116.233；p = 0.019；hs-cTnI；OR = 8.8；95%CI 1.183 - 65.475；p = 0.034）。
结论
本研究表明，在单变量和多变量线性回归模型中，阿加斯顿评分与hs心肌肌钙蛋白显著相关。Hs-cTnI能够区分不同的阿加斯顿值。本研究结果可能揭示了hs心肌肌钙蛋白关于不同阿加斯顿值的潜在临界值。试验注册心血管成像和生物标志物分析（CIBER），NCT03074253 https://clinicaltrials.gov/ct2/show/record/NCT03074253 。
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