TY  - BOOK
AU  - Epstein, Stephen E
TI  - High-Sensitivity Troponin I Levels and Coronary Artery Disease Severity, Progression, and Long-Term Outcomes
SN  - 2047-9980
PY  - 2018///
KW  - *Coronary Artery Disease/bl [Blood]
KW  - *Coronary Stenosis/bl [Blood]
KW  - *Troponin I/bl [Blood]
KW  - Aged
KW  - Biomarkers/bl [Blood]
KW  - Cause of Death
KW  - Coronary Angiography
KW  - Coronary Artery Disease/dg [Diagnostic Imaging]
KW  - Coronary Artery Disease/mo [Mortality]
KW  - Coronary Stenosis/dg [Diagnostic Imaging]
KW  - Coronary Stenosis/mo [Mortality]
KW  - Disease Progression
KW  - Female
KW  - Georgia/ep [Epidemiology]
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - Predictive Value of Tests
KW  - Prognosis
KW  - Retrospective Studies
KW  - Risk Assessment
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - Time Factors
KW  - MedStar Health Research Institute
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
KW  - Research Support, Non-U.S. Gov't
N2  - BACKGROUND: The associations between high-sensitivity troponin I (hsTnI) levels and coronary artery disease (CAD) severity and progression remain unclear. We investigated whether there is an association between hsTnI and angiographic severity and progression of CAD and whether the predictive value of hsTnI level for incident cardiovascular outcomes is independent of CAD severity; CONCLUSIONS: Higher hsTnI levels are associated with the underlying burden of coronary atherosclerosis, more rapid progression of CAD, and higher risk of all-cause mortality and incident cardiovascular events. Whether more aggressive treatment aimed at reducing hsTnI levels can modulate disease progression requires further investigation; Copyright (c) 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley; METHODS AND RESULTS: In 3087 patients (aged 63+/-12 years, 64% men) undergoing cardiac catheterization without evidence of acute myocardial infarction, the severity of CAD was calculated by the number of major coronary arteries with >=50% stenosis and the Gensini score. CAD progression was assessed in a subset of 717 patients who had undergone >=2 coronary angiograms >3 months before enrollment. Patients were followed up for incident all-cause mortality and incident cardiovascular events. Of the total population, 11% had normal angiograms, 23% had nonobstructive CAD, 20% had 1-vessel CAD, 20% had 2-vessel CAD, and 26% had 3-vessel CAD. After adjusting for age, sex, race, body mass index, smoking, hypertension, diabetes mellitus history, and renal function, hsTnI levels were independently associated with the severity of CAD measured by the Gensini score (log 2 s=0.31; 95% confidence interval, 0.18-0.44; P<0.001) and with CAD progression (log 2 s=0.36; 95% confidence interval, 0.14-0.58; P=0.001). hsTnI level was also a significant predictor of incident death, cardiovascular death, myocardial infarction, revascularization, and cardiac hospitalizations, independent of the aforementioned covariates and CAD severity
UR  - https://dx.doi.org/10.1161/JAHA.117.007914
ER  -