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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
- Source :
- Clinical Chemistry. 64:1370-1379
- Publication Year :
- 2018
- Publisher :
- Oxford University Press (OUP), 2018.
-
Abstract
- 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 hs-cTnT 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 (>14 ng/L). Patients with hs-cTnT >14 ng/L had increased LV mass (144 ± 40 g vs 116 ± 34 g; P < 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 < 0.001), and more reversible perfusion defects (P = 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.
- Subjects :
- Male
medicine.medical_specialty
HIGHLY SENSITIVE ASSAY
CARDIOVASCULAR MORTALITY
Clinical Biochemistry
Population
Myocardial Ischemia
EMISSION COMPUTED-TOMOGRAPHY
Renal function
030204 cardiovascular system & hematology
Angina Pectoris
RISK STRATIFICATION
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Troponin T
Interquartile range
Internal medicine
medicine
Humans
In patient
030212 general & internal medicine
OLDER-ADULTS
Ventricular remodeling
education
AORTIC-STENOSIS
Aged
education.field_of_study
Science & Technology
Ejection fraction
Ventricular Remodeling
business.industry
Biochemistry (medical)
Middle Aged
ta3121
medicine.disease
Medical Laboratory Technology
Echocardiography
Cardiology
CORONARY-ARTERY-DISEASE
HEART-FAILURE
Female
ATHEROSCLEROTIC PLAQUE
INFARCTION
business
Life Sciences & Biomedicine
Perfusion
Subjects
Details
- ISSN :
- 15308561 and 00099147
- Volume :
- 64
- Database :
- OpenAIRE
- Journal :
- Clinical Chemistry
- Accession number :
- edsair.doi.dedup.....f55968e64209a3f93ab0c352dbca518f