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Cardiac Troponin T Concentrations, Reversible Myocardial Ischemia, and Indices of Left Ventricular Remodeling in Patients with Suspected Stable Angina Pectoris: a DOPPLER-CIP Substudy
Akershus Univ Hosp, Norway; Univ Oslo, Norway; Brigham and Womens Hosp, MA 02115 USA; Harvard Med Sch, MA USA.
Akershus Univ Hosp, Norway; Univ Oslo, Norway.
Univ Oslo, Norway; Univ Oslo, Norway.
Turku Univ Hosp, Finland.
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2018 (English)In: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 64, no 9, p. 1370-1379Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiac troponin T concentrations measured with high-sensitivity assays (hs-cTnT) provide important prognostic information for patients with stable coronary artery disease (CAD). However, whether hsc-TnT concentrations mainly reflect left ventricular (LV) remodeling or recurrent myocardial ischemia in this population is not known. METHODS: We measured hs-cTnT concentrations in 619 subjects with suspected stable CAD in a prospectively designed multicenter study. We identified associations with indices of LV remodeling, as assessed by cardiac MRI and echocardiography, and evidence of myocardial ischemia diagnosed by single positron emission computed tomography. RESULTS: Median hs-cTnT concentration was 7.8 ng/L (interquartile range, 4.8 -11.6 ng/L), and 111 patients (18%) had hs-cTnT concentrations above the upper reference limit (amp;gt; 14 ng/L). Patients with hs-cTnT amp;gt; 14 ng/L had increased LV mass (144 +/- 40 g vs 116 +/- 34 g; P amp;lt; 0.001) and volume (179 +/- 80 mL vs 158 +/- 44 mL; P = 0.006), lower LV ejection fraction (LVEF) (59 +/- 14 vs 62 +/- 11; P = 0.006) and global longitudinal strain (14.1 +/- 3.4% vs 16.9 +/- 3.2%; P amp;lt; 0.001), and more reversible perfusion defects (P amp;lt; 0.001) and reversible wall motion abnormalities (P = 0.008). Age (P = 0.009), estimated glomerular filtration rate (P = 0.01), LV mass (P = 0.003), LVEF (P = 0.03), and evidence of reversible myocardial ischemia (P = 0.004 for perfusion defects and P = 0.02 for LV wall motion) were all associated with increasing hs-cTnT concentrations in multivariate analysis. We found analogous results when using the revised US upper reference limit of 19 ng/L. CONCLUSIONS: hs-cTnT concentrations reflect both LV mass and reversible myocardial ischemia in patients with suspected stable CAD. (c) 2018 American Association for Clinical Chemistry

Place, publisher, year, edition, pages
AMER ASSOC CLINICAL CHEMISTRY , 2018. Vol. 64, no 9, p. 1370-1379
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Cardiac and Cardiovascular Systems
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URN: urn:nbn:se:liu:diva-152632DOI: 10.1373/clinchem.2018.288894ISI: 000448300800016PubMedID: 29959147OAI: oai:DiVA.org:liu-152632DiVA, id: diva2:1262076
Note

Funding Agencies|Akershus University Hospital; Norwegian Research Council; South-Eastern Regional Health Authority; EU (FP7) framework program; South-Eastern Norway Regional Health Authority; Roche Diagnostics

Available from: 2018-11-09 Created: 2018-11-09 Last updated: 2018-11-09

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Engvall, Jan
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Clinical Physiology in LinköpingCenter for Medical Image Science and Visualization (CMIV)
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