Lavanya Narra, Oomman Abraham
Consultant Interventional Cardiologist, Department of Cardiology, KIMS Hospital, Kondapur, Hyderabad, Telangana, India, Corresponding Author.
Consultant Interventional Cardiologist, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu, India.
J Assoc Physicians India. 2025 May;73(5):25-28. doi: 10.59556/japi.73.0930.
Cardiovascular diseases (CVDs) have become a major cause of mortality in India and abroad. Various risk scores have been formulated to estimate CVD risk. The preferred biomarker for the detection of myocardial cell necrosis is cardiac troponin. Highly sensitive troponin assays are now available. Computed tomography coronary angiogram (CT-CAG) is the standard noninvasive modality to identify as well as exclude coronary artery disease (CAD). Our study aims to correlate high-sensitivity troponin I (hs-cTnI) and the QRESEARCH cardiovascular (CV) risk algorithm (QRISK3) score against CT-CAG and determine whether, by using these data, we can detect or rule out CAD accurately by noninvasive means alone.
We evaluated 100 subjects who presented with chest pain (primary prevention population) to the cardiology outpatient department. A detailed history was obtained, and blood investigations, including hs-cTnI, were conducted. The QRISK3 score was calculated, and CT-CAG was performed for all. Hs-cTnI >6 was considered significant. Those who had >50% diameter stenotic lesion(s) were deemed to have significant CAD.
In our study with 100 subjects, 80 had hs-cTnI <6, and 20 subjects had hs-cTnI >6. The QRISK3 score did not show any statistical correlation with hs-cTnI. The hs-cTnI levels were compared with CT-CAG results and found that 80% of subjects with elevated hs-cTnI had CAD.
A strong correlation between elevated hs-cTnI levels and CAD by CT-CAG was established by our study. The early detection of CAD will prompt early management and delay further progression of the disease.
心血管疾病（CVDs）已成为印度国内外死亡的主要原因。已经制定了各种风险评分来估计心血管疾病风险。检测心肌细胞坏死的首选生物标志物是心肌肌钙蛋白。现在已有高敏肌钙蛋白检测方法。计算机断层扫描冠状动脉造影（CT-CAG）是识别和排除冠状动脉疾病（CAD）的标准非侵入性检查方法。我们的研究旨在将高敏肌钙蛋白I（hs-cTnI）和QRESEARCH心血管（CV）风险算法（QRISK3）评分与CT-CAG结果进行关联，并确定通过使用这些数据，我们是否能够仅通过非侵入性手段准确检测或排除CAD。
我们评估了100名因胸痛前来心血管内科门诊就诊的受试者（一级预防人群）。获取了详细病史，并进行了包括hs-cTnI在内的血液检查。计算QRISK3评分，并对所有人进行CT-CAG检查。Hs-cTnI>6被认为具有显著性。那些有直径狭窄病变>50%的受试者被视为患有显著性CAD。
在我们对100名受试者的研究中，80名受试者的hs-cTnI<6，20名受试者的hs-cTnI>6。QRISK3评分与hs-cTnI之间未显示出任何统计学相关性。将hs-cTnI水平与CT-CAG结果进行比较，发现hs-cTnI升高的受试者中有80%患有CAD。
我们的研究证实了hs-cTnI水平升高与通过CT-CAG诊断的CAD之间存在强相关性。CAD的早期检测将促使早期治疗并延缓疾病的进一步发展。
