Effect of Coronary Atherosclerosis and Myocardial Ischemia on Plasma Levels of High-Sensitivity Troponin T and NT-proBNP in Patients With Stable Angina

被引：44

作者：

Caselli, Chiara ^{[1
]}

Prontera, Concetta ^{[2
]}

Liga, Riccardo ^{[3
]}

De Graaf, Michiel A. ^{[4
]}

Gaemperli, Oliver ^{[5
]}

Lorenzoni, Valentina ^{[6
]}

Ragusa, Rosetta ^{[6
]}

Marinelli, Martina ^{[1
]}

Del Ry, Silvia ^{[1
]}

Rovai, Daniele ^{[1
]}

Giannessi, Daniela ^{[1
]}

Aguade-Bruix, Santiago ^{[7
]}

Clemente, Alberto ^{[2
,6
]}

Bax, Jeroen J. ^{[4
]}

Lombardi, Massimo ^{[2
]}

Sicari, Rosa ^{[1
]}

Zamorano, Jose ^{[8
]}

Scholte, Arthur J. ^{[4
]}

Kaufmann, Philipp A. ^{[5
]}

Knuuti, Juhani ^{[9
,10
]}

Underwood, S. Richard ^{[11
]}

Clerico, Aldo ^{[2
]}

Neglia, Danilo ^{[1
,2
]}

机构：

[1] CNR, Inst Clin Physiol, Via Moruzzi 1, I-56100 Pisa, Italy

[2] Fdn Toscana G Monasterio, Pisa, Italy

[3] Univ Hosp Pisa, Cardiothorac & Vasc Dept, Pisa, Italy

[4] Leiden Univ, Med Ctr, Leiden, Netherlands

[5] Univ Zurich Hosp, CH-8091 Zurich, Switzerland

[6] Scuola Super Sant Anna, Pisa, Italy

[7] Hosp Univ Vall Hebron, Barcelona, Spain

[8] Univ Alcala, Hosp Ramon & Cajal, Madrid, Spain

[9] Univ Turku, Turku, Finland

[10] Turku Univ Hosp, FIN-20520 Turku, Finland

[11] Univ London Imperial Coll Sci Technol & Med, London SW7 2AZ, England

来源：

ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY | 2016年 / 36卷 / 04期

关键词：

coronary artery disease; hs cardiac troponin T; myocardial ischemia; NT-proBNP; stable angina; PRESERVED EJECTION FRACTION; BRAIN NATRIURETIC PEPTIDE; ARTERY-DISEASE; HEART-FAILURE; RELEASE; ASSAY; INSIGHTS;

D O I：

10.1161/ATVBAHA.115.306818

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective Circulating levels of high-sensitivity cardiac troponin T (hs-cTnT) and N terminal pro brain natriuretic peptide (NT-proBNP) are predictors of prognosis in patients with coronary artery disease (CAD). We aimed at evaluating the effect of coronary atherosclerosis and myocardial ischemia on cardiac release of hs-cTnT and NT-proBNP in patients with suspected CAD. Approach and Results Hs-cTnT and NT-proBNP were measured in 378 patients (60.10.5 years, 229 males) with stable angina and unknown CAD enrolled in the Evaluation of Integrated Cardiac Imaging (EVINCI) study. All patients underwent stress imaging to detect myocardial ischemia and coronary computed tomographic angiography to assess the presence and characteristics of CAD. An individual computed tomographic angiography score was calculated combining extent, severity, composition, and location of plaques. In the whole population, the median (25-75 percentiles) value of plasma hs-cTnT was 6.17 (4.2-9.1) ng/L and of NT-proBNP was 61.66 (31.2-132.6) ng/L. In a multivariate model, computed tomographic angiography score was an independent predictor of the plasma hs-cTnT (coefficient 0.06, SE 0.02; P=0.0089), whereas ischemia was a predictor of NT-proBNP (coefficient 0.38, SE 0.12; P=0.0015). Hs-cTnT concentrations were significantly increased in patients with CAD with or without myocardial ischemia (P<0.005), whereas only patients with CAD and ischemia showed significantly higher levels of NT-proBNP (P<0.001). Conclusions In patients with stable angina, the presence and extent of coronary atherosclerosis is related with circulating levels of hs-cTnT, also in the absence of ischemia, suggesting an ischemia-independent mechanism of hs-cTnT release. Obstructive CAD causing myocardial ischemia is associated with increased levels of NT-proBNP.

引用

页码：757 / 764

页数：8

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