PT - JOURNAL ARTICLE AU - Rong Bing AU - James Henderson AU - Amanda Hunter AU - Michelle C Williams AU - Alastair J Moss AU - Anoop S V Shah AU - David A McAllister AU - Marc R Dweck AU - David E Newby AU - Nicholas L Mills AU - Philip D Adamson TI - Clinical determinants of plasma cardiac biomarkers in patients with stable chest pain AID - 10.1136/heartjnl-2019-314892 DP - 2019 Nov 01 TA - Heart PG - 1748--1754 VI - 105 IP - 22 4099 - http://heart.bmj.com/content/105/22/1748.short 4100 - http://heart.bmj.com/content/105/22/1748.full SO - Heart2019 Nov 01; 105 AB - Objective Troponin and B-type natriuretic peptide (BNP) concentrations are associated with cardiovascular risk in stable patients. Understanding their determinants and identifying modifiable clinical targets may improve outcomes. We aimed to establish clinical and cardiac determinants of these biomarkers.Methods This was a prespecified substudy from the randomised Scottish Computed Tomography of the Heart trial, which enrolled patients 18–75 years with suspected stable angina between 2010 and 2014 (NCT01149590). We included patients from six centres in whom high-sensitivity troponin I and BNP were measured (Singulex Erenna). Patients with troponin >99th centile upper reference limit (10.2 ng/L) or BNP ≥400 ng/L were excluded to avoid inclusion of patients with myocardial injury or heart failure. Multivariable linear regression models were constructed with troponin and BNP as dependent variables.Results In total, 885 patients were included; 881 (99%) and 847 (96%) had troponin and BNP concentrations above the limit of detection, respectively. Participants had a slight male preponderance (n=513; 56.1%), and the median age was 59.0 (IQR 51.0–65.0) years. The median troponin and BNP concentrations were 1.4 (IQR 0.90–2.1) ng/L and 29.1 (IQR 14.0–54.0) ng/L, respectively. Age and atherosclerotic burden were independent predictors of both biomarkers. Male sex, left ventricular mass and systolic blood pressure were independent predictors of increased troponin. In contrast, female sex and left ventricular volume were independent predictors of increased BNP.Conclusions Troponin and BNP are associated with coronary atherosclerosis but have important sex differences and distinct and contrasting associations with CT-determined left ventricular mass and volume.Clinical Trial registration NCT01149590; Post-results.