Combined evaluation of
coronary artery disease and high-sensitivity cardiac troponin T for
prediction of adverse events in
patients with hypertrophic cardiomyopathy

Abstract Background This study was performed to investigate the clinical significance of combined evaluation of both coronary artery disease (CAD) and high-sensitivity cardiac troponin T (hs-cTnT) for prediction of major adverse cardiovascular events (MACEs) in patients with hypertrophic cardiomyopathy (HCM). Methods We performed clinical evaluations, including coronary artery imaging and hs-cTnT measurement, in 162 patients with HCM. Results The patients were followed up for a median period of 3.7 years (interquartile range 2.4–5.6 years; total of 632.3 person-years [PYs]), during which time MACEs occurred in 24 (14.8%) patients. The incidence of MACEs was 6.4 and 2.7 per 100 PYs for patients with CAD and normal coronary arteries, respectively; similarly, the incidence was 5.8 and 2.1 per 100 PYs in patients with an elevated hs-cTnT concentration (> 14.0 ng/L) and a normal hs-cTnT concentration, respectively. The multivariate analysis suggested that CAD and an elevated hs-cTnT concentration tended to be positively associated with MACEs. When the groups were allocated according to these two markers, the patients were divided into four groups, which further improved the predictive values. The incidence of MACEs was 10.4 per 100 PYs in the CAD and elevated hs-cTnT group, which was much higher than the incidence in all other groups (range, 2.0–3.5 per 100 PYs). With the normal coronary arteries and normal hs-cTnT group serving as a reference, the adjusted hazard ratio was 5.0 (95% confidence interval 1.0–23.8; P = 0.046) for the CAD and elevated hs-cTnT group. In addition, the subgroup analysis showed similar findings among the patients without severe CAD. Conclusions In patients with HCM, combined evaluation of both CAD and hs-cTnT might facilitate more reliable prediction of MACEs than evaluation of a single marker. These may serve as clinically useful markers to guide risk management.

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High-Sensitivity Cardiac Troponin T is Associated with SYNTAX Score and Diabetes Mellitus in Patients with Stable Coronary Artery Disease

Journal of Clinical & Experimental Cardiology ◽

10.4172/2155-9880.1000263 ◽

2013 ◽

Vol 04 (09) ◽

Author(s):

Onur Kaypakl Nermin Yıldız Koyunsever

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiac Troponin ◽

Troponin T ◽

Stable Coronary Artery Disease ◽

High Sensitivity ◽

Syntax Score ◽

Cardiac Troponin T ◽

Artery Disease

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Current Smoking Is Associated With Lower Concentrations of High-Sensitivity Cardiac Troponin T in Patients With Stable Coronary Artery Disease

Circulation ◽

10.1161/circulationaha.119.041991 ◽

2019 ◽

Vol 140 (24) ◽

pp. 2044-2046

Author(s):

Julia B. Skranes ◽

Brian L. Claggett ◽

Peder L. Myhre ◽

Magnus N. Lyngbakken ◽

Scott D. Solomon ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiac Troponin ◽

Troponin T ◽

Stable Coronary Artery Disease ◽

High Sensitivity ◽

Cardiac Troponin T ◽

Current Smoking ◽

Artery Disease

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Direct Comparison of Cardiac Troponin T and I Using a Uniform and a Sex-Specific Approach in the Detection of Functionally Relevant Coronary Artery Disease

Clinical Chemistry ◽

10.1373/clinchem.2018.286971 ◽

2018 ◽

Vol 64 (11) ◽

pp. 1596-1606 ◽

Cited By ~ 6

Author(s):

Deborah Mueller ◽

Christian Puelacher ◽

Ursina Honegger ◽

Joan E Walter ◽

Patrick Badertscher ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Diagnostic Accuracy ◽

Cardiac Troponin ◽

Troponin T ◽

High Sensitivity ◽

Emission Computed Tomography ◽

Cardiac Troponin T ◽

Artery Disease

Abstract BACKGROUND We aimed to directly compare high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the detection of functionally relevant coronary artery disease (fCAD). METHODS Consecutive patients referred with clinical suspicion of fCAD and no structural heart disease other than coronary artery disease were included. The presence of fCAD was based on rest/stress myocardial perfusion single-photon emission computed tomography/computed tomography and coronary angiography. hs-cTnI and hs-cTnT concentrations were measured in a blinded fashion. Diagnostic accuracy was quantified using the area under the ROC curve (AUC) and evaluated both for uniform use in all patients and for sex-specific use in women and men separately. The prognostic end point was major adverse cardiac events (MACEs; cardiovascular death or myocardial infarction) within 2 years. For the prognostic performance, we used a multivariable model comparison with the Akaike information criterion (AIC). RESULTS fCAD was detected in 613 of 2062 patients (29.7%) overall, 112 of 664 of women (16.9%), and 501 of 1398 of men (35.8%). hs-cTnI and hs-cTnT had comparable diagnostic accuracy when assessed for uniform use in all patients (AUC, 0.68 vs 0.66; P = 0.107) and separately in women (AUC, 0.68 vs 0.63; P = 0.068) and men (AUC, 0.65 vs 0.64; P = 0.475). However, women required lower rule-out cutoffs to achieve high sensitivity, and men needed higher rule-in cutoffs to achieve high specificity. hs-cTnI and hs-cTnT were strongly and independently associated with MACE within 2 years (P < 0.001), with comparable prognostic accuracies by the AIC. CONCLUSIONS hs-cTnI and hs-cTnT provide moderate and comparable diagnostic accuracy. Sex-specific cutoffs may be preferred. The prognostic utility of both troponins is comparable.

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