High-sensitivity cardiac troponin T level is associated with angiographic complexity of coronary artery disease: a cross-sectional study.

Abstract

High levels of high-sensitivity cardiac troponin T (hs-cTnT) are associated with coronary artery disease (CAD). The SYNTAX score (SXscore) is an angiographic tool used to grade the complexity and extent of CAD. We investigated the relationship between hs-cTnT levels and SXscore. We conducted a cross-sectional analysis of 408 patients who underwent first diagnostic coronary angiography between December 2011 and December 2012. SXscore was recorded, and serum hs-cTnT levels were measured in all patients. The median hs-cTnT level was 0.009μg/L. Elevated hs-cTnT levels (≥0.014μg/L) were observed in 136 patients (33%). Twenty-seven patients (7%) had complex CAD as defined by intermediate or high SXscores. The levels of hs-cTnT were significantly higher in patients with high or intermediate SXscores than in those with low SXscores (0.044±0.055vs. 0.018±0.058μg/L, p=0.03). Multivariate analysis identified hs-cTnT level, and diabetes mellitus as independent predictors for complex CAD. The adjusted odds ratio of hs-cTnT level for predicting complex CAD was 2.86 (95% confidence interval 1.90-4.45, p<0.0001). Predictive value of the adjusted area under the receiver operating characteristic curve for complex CAD significantly improved after inclusion of the hs-cTnT (C statistic, 0.882 vs. 0.784). Measurement of serum hs-cTnT level has an important role in the risk stratification of patients who have a plan for diagnostic coronary angiography. In patients with clinically stable angina pectoris, slightly elevated hs-cTnT levels may indicate the presence of complex CAD.