Lind Lars, Alfredsson Joakim, Andersson Jonas S O, Andersson Therese, Bergström Göran, Ekblom Örjan, Fagman Erika, Fall Tove, Hagström Emil, Isholth Hannes Holm, Janzon Magnus, Jernberg Tomas, Katsoularis Ioannis, Leander Karin, Leósdóttir Margrét, Magnusson Martin, Malinovschi Andrei, Rosengren Annika, GustavSmith J, Spaak Jonas, Svensson Per, Söderberg Stefan, Östgren Carl Johan, Engström Gunnar
Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, SE 751 85, Sweden.
Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden.
Sci Rep. 2024 Dec 16;14(1):30514. doi: 10.1038/s41598-024-82777-x.
To investigate whether coronary artery disease (CAD) burden is associated with plasma levels of the myocardial biomarkers Troponin I (TropI) and NT-proBNP in a large population-based sample using a cross-sectional design. Coronary computerized tomography (CT) angiography was performed in 25,859 subjects without a history of atherosclerotic disease from SCAPIS study (age 50-65, 52% women). TropI and NT-proBNP were measured in plasma. Segment involvement score (SIS) was the primary exposure and TropI the primary outcome. Both SIS and coronary artery calcium score, were associated with TropI levels following adjustment for age, sex and multiple confounders (p < 0.001), with similar relationships in men and women. Proximal segments from all three coronary arteries were related to TropI levels independently of one another. Adding TropI to traditional risk factors marginally increased discrimination of atherosclerosis as compared to risk factors alone (C-statistics + 0.0005, p = 0.014). SIS was related also to NT-proBNP levels, mainly in men, but with lower estimates than TropI. The burden of CAD was related to TropI levels in both men and women. All three major coronary arteries contributed to this relationship. Adding TropI to traditional risk factors resulted in only marginally improved discrimination of coronary atherosclerosis.
采用横断面设计，在一个基于大样本人群的样本中，研究冠状动脉疾病（CAD）负担是否与心肌生物标志物肌钙蛋白I（TropI）和N末端B型利钠肽原（NT-proBNP）的血浆水平相关。对来自SCAPIS研究的25859名无动脉粥样硬化疾病史的受试者（年龄50 - 65岁，52%为女性）进行冠状动脉计算机断层扫描（CT）血管造影。检测血浆中的TropI和NT-proBNP。节段累及评分（SIS）是主要暴露因素，TropI是主要结局指标。在对年龄、性别和多个混杂因素进行校正后，SIS和冠状动脉钙化评分均与TropI水平相关（p < 0.001），男性和女性的关系相似。所有三支冠状动脉的近端节段彼此独立地与TropI水平相关。与仅使用传统危险因素相比，将TropI加入传统危险因素后，对动脉粥样硬化的鉴别能力略有提高（C统计量 + 0.0005，p = 0.014）。SIS也与NT-proBNP水平相关，主要在男性中，但相关性估计值低于TropI。CAD负担在男性和女性中均与TropI水平相关。所有三支主要冠状动脉均与这种关系有关。将TropI加入传统危险因素仅导致对冠状动脉粥样硬化的鉴别能力略有改善。
