Köster Lukas, Weimann Jessica, Bernhard Alexander, Bay Benjamin, Blaum Christopher M, Lorenz Thiess, Zeller Tanja, Waldeyer Christoph, Reichenspurner Hermann, Kirchhof Paulus, Blankenberg Stefan, Magnussen Christina, Brunner Fabian J
Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Clin Transplant. 2025 Jun;39(6):e70195. doi: 10.1111/ctr.70195.
Cardiac allograft vasculopathy (CAV) remains a barrier to long-term survival after heart transplantation. Little is known about cardiovascular biomarkers in CAV and how they compare to biomarkers in atherosclerotic coronary artery disease (CAD).
This study addresses these gaps by investigating the associations of high-sensitivity troponin I and T (hsTnI/T), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hsCRP) with CAV and CAD.
Posttransplant patients undergoing angiography were matched 1:2 with nontransplant patients by age, sex, hypertension, BMI and angiographic severity of CAV and CAD. Disease severity was classified using the International Society for Heart and Lung Transplantation.
Sixty-three transplant and 126 matched nontransplant patients (median age 55.9 years, 5.8 years posttransplant, 8.5% female) were analyzed. Among transplant patients, 17.5% had mild, 7.9% moderate, 7.9% severe, and 66.7% no CAV. HsTnI/T (OR per SD = 2.21/2.38, CI = 1.17-4.66/1.21-5.69, p = 0.022/0.026) and NT-proBNP (OR per SD = 2.86, 95% CI 1.50-6.39, p = 0.004) were significantly associated with CAV. While hsTnT (OR per SD = 1.60, 95% CI 1.06-2.52, p = 0.030) and hsCRP (OR per SD = 1.61, 95% CI 1.08-2.47, p = 0.023) were significantly associated with CAD.
Distinct biomarker profiles were observed: HsTnI, hsTnT, and NT-proBNP showed associations with CAV, while hsTnT and hsCRP were associated with CAD.
心脏移植后同种异体移植物血管病变（CAV）仍然是长期生存的一个障碍。关于CAV中的心血管生物标志物以及它们与动脉粥样硬化性冠状动脉疾病（CAD）中的生物标志物相比情况如何，人们了解甚少。
本研究通过调查高敏肌钙蛋白I和T（hsTnI/T）、N末端B型利钠肽原（NT-proBNP）和高敏C反应蛋白（hsCRP）与CAV和CAD的关联来填补这些空白。
接受血管造影的移植后患者按年龄、性别、高血压、体重指数以及CAV和CAD的血管造影严重程度与非移植患者以1:2的比例进行匹配。使用国际心肺移植学会的标准对疾病严重程度进行分类。
分析了63例移植患者和126例匹配的非移植患者（中位年龄55.9岁，移植后5.8年，女性占8.5%）。在移植患者中，17.5%有轻度CAV，7.9%有中度CAV，7.9%有重度CAV，66.7%无CAV。HsTnI/T（每标准差的比值比=2.21/2.38，可信区间=1.17 - 4.66/1.21 - 5.69，p = 0.022/0.026）和NT-proBNP（每标准差的比值比=2.86，95%可信区间1.50 - 6.39，p = 0.004）与CAV显著相关。而hsTnT（每标准差的比值比=1.60，95%可信区间1.06 - 2.52，p = 0.030）和hsCRP（每标准差的比值比=1.61，95%可信区间1.08 - 2.47，p = 0.023）与CAD显著相关。
观察到了不同的生物标志物特征：HsTnI、hsTnT和NT-proBNP与CAV相关，而hsTnT和hsCRP与CAD相关。
