Dataset Information

Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease.

ABSTRACT:

Aims

We aimed to test the hypothesis if combining coronary artery calcium score (Ca-score) as a quantitative anatomical marker of coronary atherosclerosis with high-sensitivity cardiac troponin as a quantitative biochemical marker of myocardial injury provided incremental value in the detection of functionally relevant coronary artery disease (fCAD) and risk stratification.

Methods and results

Consecutive patients undergoing myocardial perfusion single-photon emission computed tomography (MPS) without prior CAD were enrolled. The diagnosis of fCAD was based on the presence of ischaemia on MPS and coronary angiography; fCAD was centrally adjudicated in the diagnostic and prognostic domain. Diagnostic accuracy was evaluated using the area under the receiver-operating characteristic curve (AUC). The composite of cardiovascular death and non-fatal acute myocardial infarction (AMI) within 730 days was the primary prognostic endpoint. Among 1715 patients eligible for the diagnostic analysis, 399 patients had fCAD. The combination of Ca-score and high-sensitivity cardiac troponin T (hs-cTnT) had good diagnostic accuracy for the diagnosis of fCAD (AUC 0.79, 95% confidence interval (CI) 0.77-0.81), but no incremental value compared with the Ca-score alone (AUC 0.79, 95% CI 0.77-0.81, P = 0.965). Similar results were observed using high-sensitivity cardiac troponin I (AUC 0.80, 95% CI 0.77-0.82) instead of hs-cTnT. Among 1709 patients (99.7%) with available follow-up, 59 patients (3.5%) suffered the composite primary prognostic endpoint (non-fatal AMI, n = 34; CV death, n = 28). Both Ca-score and hs-cTnT had independent prognostic value. Increased risk was restricted to patients with elevation in both markers.

Conclusion

The combination of the Ca-score with hs-cTnT increases the prognostic accuracy for future events but does not provide incremental value vs. the Ca-score alone for the diagnosis of fCAD.

Study registration

Clinical trial registration: NCT00470587.

SUBMITTER: Albus M

PROVIDER: S-EPMC11346366 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease.

Albus Miriam M Zimmermann Tobias T Median Daniela D Rumora Klara K Isayeva Ganna G Amrein Melissa M Schaefer Ibrahim I Walter Joan J Michel Evita E Huré Gabrielle G Strebel Ivo I Caobelli Federico F Haaf Philip P Frey Simon M SM Mueller Christian C Zellweger Michael J MJ

European heart journal. Cardiovascular Imaging 20240801 9

<h4>Aims</h4>We aimed to test the hypothesis if combining coronary artery calcium score (Ca-score) as a quantitative anatomical marker of coronary atherosclerosis with high-sensitivity cardiac troponin as a quantitative biochemical marker of myocardial injury provided incremental value in the detection of functionally relevant coronary artery disease (fCAD) and risk stratification.<h4>Methods and results</h4>Consecutive patients undergoing myocardial perfusion single-photon emission computed tom ...[more]

PMID: 38591997

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Dataset Information

Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease.

Aims

Methods and results

Conclusion

Study registration

Publications

Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease.

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