Objectives To study the relationship between high-sensitive cardiac troponin T (hs-cTnT) level and angiographic severity and extent of coronary stenosis in patients with chronic coronary artery disease (CAD), and to explore the risk factors for hs-cTnT elevation.
Methods hs-cTnT level was measured by Roche high-sensitive troponin T assay in 208 patients with suspected CAD, who were classified into CAD group (123 cases) and control group (85 cases) according to the results of coronary angiography. hs-cTnT levels and the percent of patients with elevated hs-cTnT level (above the upper reference limit) were compared between CAD group and the control group. hs-cTnT levels were also compared in CAD patients with different severities of coronary stenosis and number of vessels involved. Multivariate logistic regression was performed to analyse the risk factors independently contributing to increased hs-cTnT level.
Results Compared with the control group, hs-cTnT level was significantly higher (3.00 vs 5.90 pg/ml, P < 0.01) and the percent of patients with elevated hs-cTnT level was significantly higher (5.9% vs 23.6%, P < 0.01) in CAD group. hs-cTnT levels increased with the severity of coronary stenosis, which were respectively 4.40pg/ml, 6.90pg/ml and 15.50 pg/ml in patients with mild to moderate (< 75% stenosis), severe (75% to 99% stenosis) and occlusive coronary disease (all P < 0.05). hs-cTnT levels in patients with 2-vessel (8.14 pg/ml) and 3-vessel (12.35 pg/ml) disease were significantly higher than in patients with 1-vessel disease (4.90 pg/ml, all P < 0.05). Multivariate logistic regression analysis showed smoking and increased hs-CRP level were independent risk factors for hs-cTnT elevation.
Conclusions hs-cTnT level is associated with the severity and extent of coronary stenosis in patients with chronic CAD. Smoking and inflammatory process may contribute to hs-cTnT level elevation by involving and aggravating myocardial injury in patients with chronic CAD.