(TKP2021-EGA-23) Támogató: Innovációs és Technológiai Minisztérium
(2020-4.1.1.-TKP2020)
Thematic Excellence Programme (2020-4.1.1.-TKP2020)(NKFIH-1277-2/2020) Támogató: Innovációs
és Technológiai Minisztérium
Background
Coronary low-attenuation plaque (LAP) burden is a strong predictor of myocardial infarction
in patients with stable chest pain. We aimed to assess the relationship between LAP
burden and circulating levels of high-sensitivity cardiac troponin T (hs-cTnT), and
to explore the potential underlying etiology in patients undergoing clinically indicated
coronary CT angiography (CCTA).
Methods
A comprehensive metabolic and lipid panel, as well as C-reactive protein (CRP) and
hs-cTnT tests were obtained from consecutive patients with stable chest pain at the
time of CCTA. Qualitative and quantitative coronary plaque analysis, CT-derived fractional
flow reserve (FFR) calculation, and pericoronary adipose tissue (PCAT) attenuation
measurement around the right coronary artery were performed on CCTA images. Linear
regression analyses were performed to identify independent associations with hs-cTnT
concentration and mediation analysis was used to assess whether ischemia or markers
of inflammation mediate hs-cTnT elevation.
Results
In total, 114 patients (56.3 ± 10.6 years, 44.7 % female) were enrolled. In multivariable
analysis, age (β = 0.04 [95%CI: 0.02; 0.06], p < 0.001), female sex (β = −0.77
[95%CI: −1.20; 0.33], p < 0.001), and LAP burden (β = 0.03 [95%CI: 0.001; 0.06],
p = 0.04) were independently associated with hs-cTnT levels. Mediation analysis,
on the other hand, did not identify a significant mediating effect of lesion-specific
ischemia based on CT-FFR, circulating CRP levels, or PCAT values between LAP burden
and hs-cTnT levels (all p > 0.05).
Conclusion
Although ischemia and inflammation have previously been proposed to mediate the association
between LAP burden and hs-cTnT levels, our results did not confirm the role of these
pathophysiological pathways in patients with stable chest pain.
