High-Sensitivity Troponins and Subclinical Coronary Atherosclerosis Evaluated by Coronary Calcium Score Among Older Asians Living With Well-Controlled Human Immunodeficiency Virus
Author:
Chattranukulchai Pairoj1, Vassara Manasawee1, Siwamogsatham Sarawut2, Buddhari Wacin1, Tumkosit Monravee3, Ketloy Chutitorn4, Shantavasinkul Prapimporn5, Apornpong Tanakorn6, Lwin Hay Mar Su6, Kerr Stephen J67, Boonyaratavej Smonporn1, Avihingsanon Anchalee68, Phanuphak Praphan, Ruxrungtham Kiat, Avihingsanon Anchalee, Gatechompol Sivaporn, Lwin Hay Mar Su, Han Win Min, Woratanarat Kobchoke, Hiransuthikul Akarin, Wichiansan Thanathip, Boonrungsirisap Jedsadakorn, Kerr Stephen J, Apornpong Tanakorn, Sophonphan Jiratchaya, Phonphithak Supalak, Wongvoranet Chuleeporn, Chaiyahong Prachya, Jirapasiri Jaravee, Sarachat Paritaporn, Setta Nattawadee, Supakawee Khuanruan, Duchchanutat Supaporn, Ruengpanyathip Chavalun, Phadungphon Chowalit, Treepattanasuwan Orathai, Boonmangum Theeradej, Lertarrom Plengsri, Uanithirat Anuntaya, Chanthaburanun Sararut, Anuchadbut Anongnart, Tanjedrew Piyaporn, Longcharaen Ratree, Wongthai Niti, Sattong Threepol, Ubolyam Sasiwimol, Mahanontharit Apicha, Sopa Bunruan, Chobkarching Umaporn, Bouko Channuwat, Phongam Nuchtida, Iampornsin Thatri, Dalodom Theera, Khlaiphuengsin Apichaya, Plakunmonthon Sasitorn, Nanthapisal Kesdao, Methanggool Umaporn, Thangjitthanom Chornarin, Sirichumpa Kanokon, Chobkarjing Jutharos, Jamrasrak Adisak, Pitayanon Natthapa, Phuengchangam Engon, Chattranukulchai Pairoj, Vassara Manasawee, Buddhari Wacin, Songmuang Smonporn Boonyaratavej, Thimaporn Weerayut, Siwamogsatham Sarawut, Tumkosit Monravee, Ketloy Chutitorn, Shantavasinkul Prapimporn, Sunthomyothin Sarat, Wattanachanya Lalita, Chaiwatanarat Tawachai, Chutinet Aurauma, Vongsayan Pongpat, Samajarn Jitrada, Putcharoen Opass, Satitthummanid Sudarat, Ariyachaipanich Aekarach,
Affiliation:
1. Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and Cardiac Center, King Chulalongkorn Memorial Hospital , Bangkok , Thailand 2. Division of Hospital and Ambulatory Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and Cardiac Center, King Chulalongkorn Memorial Hospital , Bangkok , Thailand 3. Department of Radiology, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand 4. Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand 5. Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand 6. HIV-NAT, Thai Red Cross AIDS Research Centre , Bangkok , Thailand 7. Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand 8. Center of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand
Abstract
Abstract
Background
Elevated levels of high-sensitivity cardiac troponin (hs-cTn) are suggestive of myocardial cell injury and coronary artery disease. We explored the association between hs-cTn and subclinical arteriosclerosis using coronary artery calcification (CAC) scoring among 337 virally suppressed patients with human immunodeficiency virus (HIV) who were ≥50 years old and without evidence of known coronary artery disease.
Methods
Noncontrast cardiac computed tomography and blood sampling for hs-cTn, both subunit I (hs-cTnI) and subunit T (hs-cTnT), were performed. The relationship between CAC (Agatston score) and serum hs-cTn levels was analyzed using Spearman correlation and logistic regression models.
Results
The patients, of whom 62% were male, had a median age of 54 years and had been on antiretroviral therapy for a median of 16 years; the CAC score was >0 in 50% of patients and ≥100 in 16%. Both hs-cTn concentrations were positively correlated with the Agatston score, with correlation coefficients of 0.28 and 0.27 (P < .001) for hs-cTnI and hs-cTnT, respectively. hs-cTnI and hs-cTnT concentrations of ≥4 and ≥5.3 pg/mL, respectively, provided the best performance for discriminating patients with Agatston scores ≥100, with a sensitivity and specificity of 76% and 60%, respectively, for hs-cTnI and 70% and 50% for hs-cTnT. In multivariable logistic regression analysis, each log unit increase in hs-cTnI level was independently associated with increased odds of having an Agatston score ≥100 (odds ratio, 2.83 [95% confidence interval, 1.69–4.75]; P <.001). Although not an independent predictor, hs-cTnT was also associated with an increased odds of having an Agatston score ≥100 (odds ratio, 1.58 [95% confidence interval, .92–2.73]; P = .10).
Conclusions
Among Asians aged ≥50 years with well-controlled HIV infection and without established cardiovascular disease, 50% had subclinical arteriosclerosis. Increasing hs-cTnI and hs-cTnT concentrations were associated with an increased risk of severe subclinical arteriosclerosis, and hs-cTn may be a potential biomarker to detect severe subclinical arteriosclerosis.
Funder
Higher Education Research Promotion Office of the Higher Education Commission Chulalongkorn University Ratchadapiseksompotch Fund Faculty of Medicine
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Cited by
1 articles.
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