The relationship between troponin T and plaque burden in patients with stable chest pain

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Certain laboratory parameters of patients presenting with stable chest pain may also have clinical utility in estimating individual cardiovascular (CV) risk in addition to ruling out acute myocardial infarction. Therefore, it is plausible that they provide valuable information on the overall plaque burden in patients with low to intermediate CV risk who are examined due to suspected coronary artery disease (CAD). Purpose Our purpose was to investigate the potential association of certain laboratory parameters of potential cardiological relevance and the extent and severity of CAD, as assessed by coronary CT angiography (CCTA). Methods In our present study, 307 consecutive patients referred to CCTA due to suspected CAD were enrolled. A comprehensive laboratory panel (including a complete blood count, comprehensive metabolic panel, lipid panel, cardiac biomarkers, and C-reactive protein) was performed immediately before the CCTA for all patients. Segment stenosis score (SSS) was calculated on CCTA images to characterize overall plaque burden. A score was assigned to each coronary segment according to the most severe stenosis present: <25%: 1 point, 25–49%: 2 points, 50–69%: 3 points, ≥70: 4 points. The patient's SSS score was calculated as the sum of each score. Predictors of SSS were determined by linear regression analysis incorporating traditional CV risk factors and laboratory parameters. Results The mean age of the patients was 57.1 ± 11.5 years, 65% (200/307) had CAD. The independent predictors of SSS were female sex (ß = −1.63 [95%CI: −2.28–−0.98], p<0.001), age (ß = 0.08 [95%CI: 0.05–0.16], p<0.001), alcohol consumption (ß = 0.26 [95%CI: 0.06–0.47], p = 0.01), hypertension (ß = 0.70 [95%CI: 0.07–1.33], p = 0.03), blood glucose level (ß = 0.40 [95%CI: 0.05–0.75], p = 0.03), and troponin T level (ß = 0.08 [95%CI: 0.006–0.16], p = 0.03). Conclusions The elevation of troponin T in patients with stable angina was independently associated with SSS, which might be due to subclinical plaque ruptures causing myocardial injury. The measurement of troponin T may allow more precise risk stratification of patients with stable angina.