Author + information
- Philip D. Adamson,
- Amanda Hunter,
- Anoop Shah,
- David McAllister,
- Tania Pawade,
- Michelle Williams,
- Edwin Van Beek,
- Nicholas Mills and
- David Newby
Background: High-sensitivity assays can quantify cardiac troponin I (hs-cTnI) concentrations in nearly all individuals. We determined whether hs-cTnI could improve estimates of the pre-test probability of obstructive coronary artery disease (CAD) in patients with suspected stable angina.
Methods: In a pre-specified sub-study of the Scottish COmputed Tomography of the Heart (SCOT-HEART) trial, hs-cTnI was measured using the Singulex assay (limit of detection 0.1 ng/L) in 943 adults with suspected stable angina who had undergone computed tomography coronary angiography. Rates of obstructive CAD (diameter stenosis ≥50% in ≥1 major epicardial vessel) were compared with the pre-test probability determined by the European Society of Cardiology (ESC) CAD Consortium risk model with and without plasma hs-cTnI concentrations.
Results: Higher hs-cTnI concentrations were associated with obstructive CAD and a 5-fold increase across quintiles (9 to 48%, p<0.001) independent of known cardiovascular risk factors (odds ratio 1.35 [95% CI 1.25-1.46] per doubling of troponin). Plasma hs-cTnI improved the discrimination and calibration of the ESC model for identifying obstructive CAD (c-statistic 0.785 to 0.800, p<0.003; net reclassification index 0.14, p<0.001).
Conclusions: Plasma hs-cTnI concentrations independently predict the presence of obstructive CAD in patients with suspected stable angina. This may improve the selection of patients for further investigation and treatment of obstructive CAD.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 10:00 a.m.-10:10 a.m.
Session Title: Blips, Trops, and Chips: New Ways to Diagnose CAD
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1217M-05
- 2017 American College of Cardiology Foundation