Correlation of concentrations of high-sensitivity troponin T and high-sensitivity C-reactive protein with plaque progression as measured by CT coronary angiography.
BACKGROUND
Elevated levels of inflammatory biomarkers are associated with increased cardiovascular morbidity and mortality.


OBJECTIVE
We sought to determine whether elevated concentrations of high-sensitivity troponin T (hs-TnT) and high-sensitivity C-reactive protein (hs-CRP) predict progression of coronary artery disease (CAD) as determined by coronary CT angiography (coronary CTA).


METHODS
Patients presenting to the emergency department with acute chest pain who initially showed no evidence of an acute coronary syndrome underwent baseline and follow-up coronary CTA (median follow-up, 23.9 months) using identical acquisition and reconstruction parameters. Coronary CTA data of each major coronary artery were co-registered. Cross-sections were assessed for the presence of calcified and noncalcified plaques. Progression of atherosclerotic plaque and change of plaque composition from noncalcified to calcified plaque was evaluated and correlated to levels of hs-TnT and hs-CRP at the time of the baseline CT.


RESULTS
Fifty-four patients (mean age, 54.1 years; 59% male) were included, and 6775 cross-sections were compared. CAD was detected in 12.2 ± 21.2 cross-sections per patient at baseline. Prevalence of calcified plaque increased by 1.5 ± 2.4 slices per patient (P < .0001) over the follow-up period. On average, 1.6 ± 3.6 slices with new noncalcified plaque were found per patient (P < .0001) and 0.7 ± 1.7 slices with pre-existing noncalcified plaque had progressed to calcified plaque (P < .0001). After multivariate adjustment, change of overall CAD burden was predicted by baseline hs-TnT and hs-CRP (r = 0.29; P = .039 and r = 0.40; P = .004). Change of plaque composition was associated with baseline hs-TnT (r = 0.29; P = .03).


CONCLUSION
Concentrations of hs-TnT and hs-CRP are weakly associated with a significant increase in CAD burden and change in plaque composition over 24 months independent of baseline risk factors.
['Seifarth|Harald|H|', 'Schlett|Christopher L|CL|', 'Lehman|Sam J|SJ|', 'Bamberg|Fabian|F|', 'Donnelly|Patrick|P|', 'Januzzi|James L|JL|', 'Koenig|Wolfgang|W|', 'Truong|Quynh A|QA|', 'Hoffmann|Udo|U|']
D000328:Adult D000368:Aged D015415:Biomarkers D002097:C-Reactive Protein D017023:Coronary Angiography D003324:Coronary Artery Disease D003331:Coronary Vessels D018450:Disease Progression D005260:Female D005858:Germany D006801:Humans D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D058226:Plaque, Atherosclerotic D011237:Predictive Value of Tests D015995:Prevalence D011446:Prospective Studies D012307:Risk Factors D013997:Time Factors D014057:Tomography, X-Ray Computed D020107:Troponin T D015854:Up-Regulation D061205:Vascular Calcification
Plaque progression Coronary artery disease Coronary CT angiography Cardiac biomarker Coronary atherosclerotic plaque