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Cardiac troponin I and T for ruling out coronary artery disease in suspected chronic coronary syndrome

Permanent link
https://hdl.handle.net/10037/25097
DOI
https://doi.org/10.1038/s41598-022-04850-7
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Date
2022-01-18
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Author
Tveit, Sjur Hansen; Myhre, Peder Langeland; Hanssen, Tove Aminda; Forsdahl, Signe Helene; Iqbal, Amjid; Omland, Torbjørn; Schirmer, Henrik
Abstract
To compare the performance of high-sensitivity cardiac troponin I and T (hs-cTnI; hs-cTnT) in diagnosing obstructive coronary artery disease (CAD50) in patients with suspected chronic coronary syndrome (CCS). A total of 706 patients with suspected CCS, referred for Coronary Computed Tomography Angiography, were included. cTn concentrations were measured using the Singulex hs-cTnI (limit of detection [LoD] 0.08 ng/L) and Roche hs-cTnT (LoD 3 ng/L) assays. Obstructive coronary artery disease (CAD50) was defned as ≥ 50% coronary stenosis. Cardiovascular risk was determined by the NORRISK2-score. Median age of the patients was 65 (range 28–87) years, 35% were women. All patients had hs-cTnI concentrations above the LoD (median 1.9 [Q1-3 1.2–3.6] ng/L), 72% had hs-cTnT above the LoD (median 5 [Q1-3 2–11] ng/L). There was a graded relationship between hs-cTn concentrations and coronary artery calcium. Only hs-cTnI remained associated with CAD50 in adjusted analyses (OR 1.20 95% Confdence Interval [1.05–1.38]), p = 0.009). The C-statistics for hs-cTnI and hs-cTnT were 0.65 (95% CI [0.60–0.69]) and 0.60 (0.56–0.64). The highest specifcity and negative predictive values for CAD50 were in the lowest NORRISK2-tertile. hs-cTn concentrations provide diagnostic information in patients with suspected CCS, with superior performance of hs-cTnI compared to hs-cTnT in regard to CAD50. The diagnostic performance appeared best in those with low cardiovascular risk.
Publisher
Nature
Citation
Tveit SH, Myhre PL, Hanssen TA, Forsdahl SH, Iqbal A, Omland T, Schirmer H. Cardiac troponin I and T for ruling out coronary artery disease in suspected chronic coronary syndrome. Scientific Reports. 2022;12:945
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