Guler Arda, Turkmen Irem, Atmaca Sezgin, Karakurt Huseyin, Kahraman Serkan, Aydin Sinem, Sevinc Samet, Tukenmez Karakurt Seda, Turkvatan Cansever Aysel, Erturk Mehmet, Babur Guler Gamze
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istasyon Mahallesi, Turgut Ozal Bulvarı, No: 11, Küçükçekmece/Istanbul, Turkey.
Department of Radiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Heart Vessels. 2023 Nov;38(11):1329-1336. doi: 10.1007/s00380-023-02287-0. Epub 2023 Jul 7.
In this study, our aim was to investigate the role of cardiac biomarkers in predicting the presence of significant coronary artery disease in hypertrophic cardiomyopathy (HCM) patients.
The study population was composed of hypertrophic cardiomyopathy patients who underwent coronary angiography at a single center between June 2021 and March 2023, and whose cardiac biomarkers were evaluated before the procedure. HCM patients were screened retrospectively. Significant CAD was defined as > 50% stenosis of the left main coronary artery or > 70% stenosis in a major coronary vessel. Demographic, echocardiographic and cardiac biomarker values were compared between the two groups.
A total of 123 patients were evaluated. Significant CAD was detected in 39 (31.7%) patients. Patients with significant CAD had higher CK-MB values than those without CAD [2.8 (2.1-4.0) vs. 3.4 (2.8-4.6), p = 0.036], and a higher level of high-sensitivity troponin T (hs-TnT) than those without CAD (24 vs. 17.8, p = 0.022). the NT-proBNP/hs-TnT ratio was found to be significantly lower in patients with CAD than in those with CAD (31.4 vs. 21.4, p = 0.019). In multivariate anaylsis, NT-proBNP/hs-TnT was determined as an independent predictor for significant CAD. In ROC analysis, NT-proBNP/hs-TnT ratio lower than the cut-off value of 30.7 could detect the presence of significant CAD with 76.9% sensitivity and 53.6% specificity (AUC: 0.632, 95% CI: 0.528-0.736, p = 0.019).
To sum up, we suggest that cardiac biomarkers were valuable and simple parameters in terms of significant CAD in HCM patients.
在本研究中，我们的目的是调查心脏生物标志物在预测肥厚型心肌病（HCM）患者显著冠状动脉疾病存在中的作用。
研究人群由2021年6月至2023年3月在单一中心接受冠状动脉造影的肥厚型心肌病患者组成，且其心脏生物标志物在手术前进行了评估。对HCM患者进行回顾性筛查。显著CAD定义为左主干冠状动脉狭窄>50%或主要冠状动脉血管狭窄>70%。比较两组患者的人口统计学、超声心动图和心脏生物标志物值。
共评估了123例患者。39例（31.7%）患者检测到显著CAD。有显著CAD的患者CK-MB值高于无CAD的患者[2.8（2.1 - 4.0）对3.4（2.8 - 4.6），p = 0.036]，且高敏肌钙蛋白T（hs-TnT）水平高于无CAD的患者（24对17.8，p = 0.022）。发现CAD患者的NT-proBNP/hs-TnT比值显著低于无CAD患者（31.4对21.4，p = 0.019）。在多变量分析中，NT-proBNP/hs-TnT被确定为显著CAD的独立预测因子。在ROC分析中，NT-proBNP/hs-TnT比值低于临界值30.7可检测到显著CAD的存在，灵敏度为76.9%，特异性为53.6%（AUC：0.632，95%CI：0.528 - 0.736，p = 0.019）。
总之，我们认为心脏生物标志物对于HCM患者的显著CAD而言是有价值且简单的参数。
