Publication

Determinants of Troponin Release in Patients with Stable Coronary Artery Disease: Insights from CT Angiography Characteristics of Atherosclerotic Plaque

Cardiac

Heart. 2011 May;97(10):823-31.

Authors:

G. Korosoglou, S. Lehrke S, D. Mueller, W. Hosch, HU. Kauczor, PM. Humpert, E. Giannitsis, HA. Katus

Summary

The study investigated the relationship between high-sensitivity troponin T (hs-TnT) levels and coronary plaque characteristics in 124 patients with stable angina. Using coronary CT angiography (CCTA), researchers assessed plaque composition (calcified vs. non-calcified), burden, and remodeling patterns.

Key findings include:

  • Non-calcified plaque burden demonstrated the strongest association with hs-TnT levels (r = 0.79, p < 0.001), with patients having exclusively non-calcified plaques showing significantly higher hs-TnT (12.6 ± 5.2 pg/mL) compared to those with normal coronaries (8.3 ± 2.6 pg/mL) or calcified plaques (8.8 ± 3.0 pg/mL)
  • Positive remodeling (vessel expansion at plaque sites) further elevated hs-TnT (26.3 ± 6.5 pg/mL, p < 0.001), suggesting a link to subclinical plaque instability.
  • Calcified plaque burden showed only weak correlation (r = 0.35), reinforcing that non-calcified, lipid-rich plaques—prone to rupture—drive troponin release.
The study posits that microembolization from vulnerable plaques may cause myocardial injury, detectable via hs-TnT, even in stable patients. These findings position hs-TnT as a biomarker for identifying high-risk atherosclerosis, independent of stenosis severity. The results align with broader evidence linking troponin elevations to coronary plaque burden and adverse outcomes.

Go back