Cardiac biomarkers for detection of coronary artery disease in the community

Lars Lind; Joakim Alfredsson; Jonas S O Andersson; Therese Andersson; Göran Bergström; Örjan Ekblom; Erika Fagman; Tove Fall; Emil Hagström; Hannes Holm Isholth; Magnus Janzon; Tomas Jernberg; Ioannis Katsoularis; Karin Leander; Margrét Leósdóttir; Martin Magnusson; Andrei Malinovschi; Annika Rosengren; J GustavSmith; Jonas Spaak; Per Svensson; Stefan Söderberg; Carl Johan Östgren; Gunnar Engström

doi:10.1038/s41598-024-82777-x

Cardiac biomarkers for detection of coronary artery disease in the community

Sci Rep. 2024 Dec 16;14(1):30514. doi: 10.1038/s41598-024-82777-x.

Authors

Lars Lind¹, Joakim Alfredsson², Jonas S O Andersson³, Therese Andersson⁴, Göran Bergström^{5

6}, Örjan Ekblom⁷, Erika Fagman^{8

9}, Tove Fall¹⁰, Emil Hagström¹¹, Hannes Holm Isholth^{12

13}, Magnus Janzon², Tomas Jernberg¹⁴, Ioannis Katsoularis⁴, Karin Leander¹⁵, Margrét Leósdóttir^{12

13}, Martin Magnusson^{12

13

16

17}, Andrei Malinovschi¹⁸, Annika Rosengren^{5

19}, J GustavSmith^{5

20

21

22}, Jonas Spaak¹⁴, Per Svensson^{23

24}, Stefan Söderberg⁴, Carl Johan Östgren^{25

26}, Gunnar Engström¹²

Affiliations

¹ Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, SE 751 85, Sweden. lars.lind@medsci.uu.se.
² Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden.
³ Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Umeå, Sweden.
⁴ Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden.
⁵ Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁶ Region Västra Götaland, Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁷ Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden.
⁸ Region Västra Götaland, Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁹ Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁰ Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden.
¹¹ Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
¹² Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
¹³ Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
¹⁴ Departmentof Clinical Sciences, Danderyd University Hospital, Karolinska Institute, Stockholm, Sweden.
¹⁵ Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
¹⁶ Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
¹⁷ Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden.
¹⁸ Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
¹⁹ Department of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
²⁰ Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
²¹ Wallenberg Center for Molecular Medicine, Lund University Diabetes Center, Lund university, Lund, Sweden.
²² Region Västra Götaland, Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
²³ Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden.
²⁴ Department of Cardiology, Södersjukhuset, Stockholm, Sweden.
²⁵ CMIV Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
²⁶ Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Abstract

To investigate whether coronary artery disease (CAD) burden is associated with plasma levels of the myocardial biomarkers Troponin I (TropI) and NT-proBNP in a large population-based sample using a cross-sectional design. Coronary computerized tomography (CT) angiography was performed in 25,859 subjects without a history of atherosclerotic disease from SCAPIS study (age 50-65, 52% women). TropI and NT-proBNP were measured in plasma. Segment involvement score (SIS) was the primary exposure and TropI the primary outcome. Both SIS and coronary artery calcium score, were associated with TropI levels following adjustment for age, sex and multiple confounders (p < 0.001), with similar relationships in men and women. Proximal segments from all three coronary arteries were related to TropI levels independently of one another. Adding TropI to traditional risk factors marginally increased discrimination of atherosclerosis as compared to risk factors alone (C-statistics + 0.0005, p = 0.014). SIS was related also to NT-proBNP levels, mainly in men, but with lower estimates than TropI. The burden of CAD was related to TropI levels in both men and women. All three major coronary arteries contributed to this relationship. Adding TropI to traditional risk factors resulted in only marginally improved discrimination of coronary atherosclerosis.

Keywords: Coronary atherosclerosis; Epidemiology; NT-proBNP; Population; Troponin.

MeSH terms

Aged
Biomarkers* / blood
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease* / blood
Coronary Artery Disease* / diagnosis
Coronary Artery Disease* / diagnostic imaging
Coronary Vessels / diagnostic imaging
Coronary Vessels / pathology
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Natriuretic Peptide, Brain* / blood
Peptide Fragments* / blood
Risk Factors
Troponin I* / blood

Substances

Biomarkers
Peptide Fragments
Natriuretic Peptide, Brain
pro-brain natriuretic peptide (1-76)
Troponin I