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Cardiac troponin I and T for ruling out coronary artery disease in suspected chronic coronary syndrome
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Cardiac troponin I and T for ruling out coronary artery disease in suspected chronic coronary syndrome
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Journal Article
Cardiac troponin I and T for ruling out coronary artery disease in suspected chronic coronary syndrome
2022
Overview
To compare the performance of high-sensitivity cardiac troponin I and T (hs-cTnI; hs-cTnT) in diagnosing obstructive coronary artery disease (CAD
50
) 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 (CAD
50
) was defined 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 CAD
50
in adjusted analyses (OR 1.20 95% Confidence 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 specificity and negative predictive values for CAD
50
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 CAD
50
. The diagnostic performance appeared best in those with low cardiovascular risk.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ Acute Coronary Syndrome - diagnosis
/ Acute Coronary Syndrome - metabolism
/ Adult
/ Aged
/ Computed Tomography Angiography - methods
/ Coronary Artery Disease - diagnosis
/ Coronary Artery Disease - metabolism
/ Female
/ Humanities and Social Sciences
/ Humans
/ Male
/ Science
/ Stenosis
/ Troponin
