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Effect of Coronary Atherosclerosis and Myocardial Ischemia on Plasma Levels of High-Sensitivity Troponin T and NT-proBNP in Patients With Stable Angina.
Caselli, Chiara; Prontera, Concetta; Liga, Riccardo; De Graaf, Michiel A; Gaemperli, Oliver; Lorenzoni, Valentina; Ragusa, Rosetta; Marinelli, Martina; Del Ry, Silvia; Rovai, Daniele; Giannessi, Daniela; Aguade-Bruix, Santiago; Clemente, Alberto; Bax, Jeroen J; Lombardi, Massimo; Sicari, Rosa; Zamorano, José; Scholte, Arthur J; Kaufmann, Philipp A; Knuuti, Juhani; Underwood, S Richard; Clerico, Aldo; Neglia, Danilo.
Afiliação
  • Caselli C; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Prontera C; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Liga R; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • De Graaf MA; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Gaemperli O; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Lorenzoni V; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Ragusa R; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Marinelli M; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Del Ry S; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Rovai D; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Giannessi D; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Aguade-Bruix S; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Clemente A; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Bax JJ; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Lombardi M; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Sicari R; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Zamorano J; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Scholte AJ; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Kaufmann PA; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Knuuti J; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Underwood SR; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Clerico A; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
  • Neglia D; From the CNR, Institute of Clinical Physiology, Pisa, Italy (C.C., M.M., S.D.R., D.R., D.G., R.S., D.N.); Fondazione Toscana G. Monasterio, Pisa, Italy (C.P., A.C., M.L., A.C., D.N.); Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy (R.L.); Leiden University Medical Center
Arterioscler Thromb Vasc Biol ; 36(4): 757-64, 2016 Apr.
Article em En | MEDLINE | ID: mdl-26868212
ABSTRACT

OBJECTIVE:

Circulating levels of high-sensitivity cardiac troponin T (hs-cTnT) and N terminal pro brain natriuretic peptide (NT-proBNP) are predictors of prognosis in patients with coronary artery disease (CAD). We aimed at evaluating the effect of coronary atherosclerosis and myocardial ischemia on cardiac release of hs-cTnT and NT-proBNP in patients with suspected CAD. APPROACH AND

RESULTS:

Hs-cTnT and NT-proBNP were measured in 378 patients (60.1±0.5 years, 229 males) with stable angina and unknown CAD enrolled in the Evaluation of Integrated Cardiac Imaging (EVINCI) study. All patients underwent stress imaging to detect myocardial ischemia and coronary computed tomographic angiography to assess the presence and characteristics of CAD. An individual computed tomographic angiography score was calculated combining extent, severity, composition, and location of plaques. In the whole population, the median (25-75 percentiles) value of plasma hs-cTnT was 6.17 (4.2-9.1) ng/L and of NT-proBNP was 61.66 (31.2-132.6) ng/L. In a multivariate model, computed tomographic angiography score was an independent predictor of the plasma hs-cTnT (coefficient 0.06, SE 0.02; P=0.0089), whereas ischemia was a predictor of NT-proBNP (coefficient 0.38, SE 0.12; P=0.0015). Hs-cTnT concentrations were significantly increased in patients with CAD with or without myocardial ischemia (P<0.005), whereas only patients with CAD and ischemia showed significantly higher levels of NT-proBNP (P<0.001).

CONCLUSIONS:

In patients with stable angina, the presence and extent of coronary atherosclerosis is related with circulating levels of hs-cTnT, also in the absence of ischemia, suggesting an ischemia-independent mechanism of hs-cTnT release. Obstructive CAD causing myocardial ischemia is associated with increased levels of NT-proBNP.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fragmentos de Peptídeos / Doença da Artéria Coronariana / Isquemia Miocárdica / Troponina T / Peptídeo Natriurético Encefálico / Angina Estável Idioma: En Ano de publicação: 2016 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fragmentos de Peptídeos / Doença da Artéria Coronariana / Isquemia Miocárdica / Troponina T / Peptídeo Natriurético Encefálico / Angina Estável Idioma: En Ano de publicação: 2016 Tipo de documento: Article