Correlation between high-sensitivity cardiac troponin T and the characteristics of coronary atherosclerosis

doi:10.3969/j.issn.1673-8640.2019.01.003

Abstract

Abstract:

Objective To evaluate the correlation between high-sensitivity cardiac troponin （hs-cTn）T and the severity of coronary atherosclerosis according the results of medical imaging. Methods A total of 436 patients with suspected coronary atherosclerosis disease（CAD） and undergoing coronary computed tomography （CT） were enrolled. There were 222 cases of CAD（CAD group）and 214 cases of non-CAD（control group）. Serum hs-cTnT,blood glucose （Glu）,blood urea nitrogen（BUN）,creatinine （Cr） and uric acid（UA） levels were determined,and estimated glomerular filtration rate （eGFR） was calculated. The correlation between hs-cTnT and the severity of coronary atherosclerosis was analyzed from 3 aspects,including the number of stenosed vessels,the degree of stenosis and the vulnerability of plaques. All subjects were classified according to hs-cTnT quartile distribution （Q1,Q2,Q3 and Q4 from low to high）. The percentages of patients with stenosed vessels,stenosis and plaques in Q1-Q4 were compared. Pearson correlation analysis and Spearman correlation analysis were used to evaluate the correlation of these indicators. Logistic regression analysis was used for multivariate analysis. Results Hs-cTnT,coronary artery calcification score （CACS）,Glu and UA increased with the increasing number of stenosed vessels （P<0.05）,while eGFR decreased（P<0.05）. Hs-cTnT,CACS,Glu,UA,Cr and BUN increased with the degree of stenosis （P<0.05）. Pearson correlation analysis showed that hs-cTnT was positively correlated with BUN,Cr,UA and Glu（r=0.312,0.239,0.134 and 0.131,respectively,P<0.05）. The quartile distribution of hs-cTnT was positively correlated with the number of stenosed vessels,the degree of stenosis and ts in Q1 decreased. After adjusting for traditional risk factors （age,sex,hypertension,diabetes mellitus,smoking and drinking） and renal function indhe vulnerability of plaques（r_s=0.249,0.252 and 0.239,respectively,P<0.01）. The percentages in Q1-Q4 had statistical significance with those in control group （P<0.05）. With the increasing number of stenosed vessels,the degree of stenosis and the vulnerability of plaques,the percentages in Q4 increased,while the percentageices （BUN,Cr,UA and eGFR）,hs-cTnT could not be an independent predictive factor for coronary atherosclerosis. Conclusions Although hs-cTnT is closely correlated with the severity of coronary atherosclerosis,but it is also affected by sex,age,renal function and other underlying diseases,so it can not be an independent predictive factor for coronary atherosclerosis.

Key words: High-sensitivity cardiac troponin T, Coronary atherosclerosis, Coronary atherosclerosis disease, Computed tomography

CLC Number:

R446.1

WANG Kaijuan, LI Tiewei, WANG Zongjian, CHEN Xi, GAO Xiaojing, LIN Yahui, ZHOU Zhou, KANG Jinsuo. Correlation between high-sensitivity cardiac troponin T and the characteristics of coronary atherosclerosis[J]. Laboratory Medicine, 2019, 34(1): 11-18.

Figures/Tables 6

References 18

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组别	例数	CACS（分）	Glu（mmol/L）	UA（μmol/L）
对照组	214	0	5.28±0.90	327.06±90.50
单支病变组	146	49（5~214）^*	5.59±1.45	323.07±91.45
2支病变组	43	103（42~265）^*	5.98±2.06^*	359.70±97.90
3支及以上病变组	33	427（313~1 261）^*#△	6.10±1.46^*	376.26±99.59
组别	Cr（μmol/L）	BUN（mmol/L）	hs-cTnT（pg/mL）	eGFR（mL/min）
对照组	69.4±14.3	5.42±1.63	4.44（3.00~6.52）	96.3±12.4
单支病变组	77.6±11.5	5.93±2.06	5.34（4.10~8.34）^*	92.1±12.8^*
2支病变组	77.9±19.5	5.90±1.69	7.11（5.14~15.96）^*#	90.1±9.7^*
3支及以上病变组	79.0±34.5^*	6.79±2.16^*	8.31（5.10~23.63）^*#	85.6±15.2^*#

组别	例数	CACS（分）	Glu（mmol/L）	UA（μmol/L）
对照组	214	0	5.28±0.90	327.06±90.50
单支病变组	146	49（5~214）^*	5.59±1.45	323.07±91.45
2支病变组	43	103（42~265）^*	5.98±2.06^*	359.70±97.90
3支及以上病变组	33	427（313~1 261）^*#△	6.10±1.46^*	376.26±99.59
组别	Cr（μmol/L）	BUN（mmol/L）	hs-cTnT（pg/mL）	eGFR（mL/min）
对照组	69.4±14.3	5.42±1.63	4.44（3.00~6.52）	96.3±12.4
单支病变组	77.6±11.5	5.93±2.06	5.34（4.10~8.34）^*	92.1±12.8^*
2支病变组	77.9±19.5	5.90±1.69	7.11（5.14~15.96）^*#	90.1±9.7^*
3支及以上病变组	79.0±34.5^*	6.79±2.16^*	8.31（5.10~23.63）^*#	85.6±15.2^*#

组别	例数	CACS（分）	Glu（mmol/L）	UA（μmol/L）
对照组	214	0	5.28±0.90	327.06±90.50
轻度狭窄组	116	29（7~82）^*	5.52±1.29	344.06±95.81
中度狭窄组	65	50（6~267）^*	5.64±1.48^*	355.04±99.04^*
重度狭窄组	41	214（14~462）^*#△	6.12±1.98^*#△	361.8±97.56^*
组别	Cr（μmol/L）	BUN（mmol/L）	hs-cTnT（pg/mL）	eGFR（mL/min）
对照组	69.4±14.3	5.42±1.63	4.44（3.00~6.52）	96.3±12.4
轻度狭窄组	74.1±15.2^*	5.75±1.91	4.92（3.49~7.73）^*	90.8±11.7^*
中度狭窄组	76.1±15.9^*	5.90±1.56^*	5.08（4.03~7.92）^*	90.6±13.4^*
重度狭窄组	78.2±24.3^*	6.40±1.90^*#	7.82（5.93~17.74）^*#△	91.9±15.3

组别	例数	CACS（分）	Glu（mmol/L）	UA（μmol/L）
对照组	214	0	5.28±0.90	327.06±90.50
轻度狭窄组	116	29（7~82）^*	5.52±1.29	344.06±95.81
中度狭窄组	65	50（6~267）^*	5.64±1.48^*	355.04±99.04^*
重度狭窄组	41	214（14~462）^*#△	6.12±1.98^*#△	361.8±97.56^*
组别	Cr（μmol/L）	BUN（mmol/L）	hs-cTnT（pg/mL）	eGFR（mL/min）
对照组	69.4±14.3	5.42±1.63	4.44（3.00~6.52）	96.3±12.4
轻度狭窄组	74.1±15.2^*	5.75±1.91	4.92（3.49~7.73）^*	90.8±11.7^*
中度狭窄组	76.1±15.9^*	5.90±1.56^*	5.08（4.03~7.92）^*	90.6±13.4^*
重度狭窄组	78.2±24.3^*	6.40±1.90^*#	7.82（5.93~17.74）^*#△	91.9±15.3

组别	例数	CACS（分）	Glu（mmol/L）	UA（μmol/L）
对照组	214	0	5.28±0.90	327.06±90.50
钙化斑块组	123	55（15~218）^*	5.64±1.31^*	352.46±85.28^*
混合斑块组	46	118（37~336）^*	5.46±0.97	369.79±133.61^*
非钙化斑块组	53	10（0~76）^*#	6.20±2.31^*#△	341.72±89.76
组别	Cr（μmol/L）	BUN（mmol/L）	hs-cTnT（pg/mL）	eGFR（mL/min）
对照组	69.4±14.3	5.42±1.63	4.44（3.00~6.52）	96.3±12.4
钙化斑块组	74.8±15.2^*	5.87±1.56^*	5.15（3.79~7.82）^*	90.2±10.8^*
混合斑块组	74.8±16.1^*	5.90±1.92	5.95（4.09~11.64）^*	90.4±16.1^*
非钙化斑块组	78.2±22.3^*	6.41±1.96^*	6.27（4.81~9.98）^*	92.3±12.0^*