Association of Cardiovascular Biomarkers With Cardiac Allograft Vasculopathy and Atherosclerotic Coronary Artery Disease

Background: 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).Purpose: 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.Methods: 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.Results: 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.Conclusion: Distinct biomarker profiles were observed: HsTnI, hsTnT, and NT-proBNP showed associations with CAV, while hsTnT and hsCRP were associated with CAD.