Author + information
- Rikuta Hamaya,
- Taishi Yonetsu,
- Tadashi Murai,
- Yoshihisa Kanaji,
- Masahiro Hoshino,
- Masahiro Hada,
- Takayuki Niida,
- Sadamitsu Ichijo,
- Yoshinori Kanno and
- Tsunekazu Kakuta
Background: Circulating high-sensitivity cardiac troponin-I (hs-cTnl) and N-terminal pro brain natriuretic peptide (NT-proBNP) are powerful predictors of adverse cardiac outcomes in patients with coronary artery disease (CAD). We investigated the association of plasma levels of hs-cTnI and NT-proBNP with coronary physiological parameters obtained by invasive catheterization.
Methods: This study included 365 patients with suspected stable CAD (67.4±9.3 years, 70 females) who underwent coronary angiography and the evaluation of fractional flow reserve (FFR), coronary flow reserve (CFR) and the index of microvascular resistance (IMR). Baseline hs-cTnl and NT-proBNP were assessed before catheterization. Patients were divided into the highest quartiles and the remainings of hs-cTnl (High-cTnl vs. Not-high-cTnl) and NT-proBNP (High-BNP vs. Not-high-BNP), respectively. Physiological parameters were compared between these corresponding groups. Independent predictors for high hs-cTnl and NT-proBNP groups were evaluated using univariate and multivariate linear regression analysis.
Results: The dividing thresholds of hs-cTnl and NT-proBNP values were 9 ng/L and 233 ng/L, respectively. Median FFR, CFR, and IMR values were 0.82 (0.76–0.87), 2.9 (2.0–4.1) and 16.8 (12.0–25.1), respectively. FFR and CFR were significantly lower in High-cTnl group than in Not-high-cTnl group (FFR: 0.79 vs. 0.83, p=0.008, CFR: 2.3 vs. 3.1, p<0.001), whereas no significant difference was observed in IMR. High-BNP group had lower CFR and higher IMR than Not-high-BNP group (CFR: 2.4 vs. 3.0, p=0.001, IMR: 17.9 vs. 16.6, p=0.03), while FFR was not significantly different between the groups. In multivariate linear regression analysis, low CFR was independently associated with high hs-cTnl (coefficient −0.61, SE 0.25, p=0.01), and high IMR was significantly related with high NT-proBNP (coefficient 3.8, SE 1.1, p<0.001).
Conclusions: CFR and FFR were associated with increased levels of hs-cTnI, while CFR and IMR were associated with high NT-proBNP, which may highlight the differential mechanistic relevance of physiological parameters in myocardium and epicardial arteries.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Interventional Cardiology: Intravascular Physiology and Endothelial Function
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1115-168
- 2017 American College of Cardiology Foundation