High-sensitivity Troponin in Predicting Coronary Artery Disease for Primary Prevention in Indian Population.

Objectives: Cardiovascular diseases (CVDs) have become a major cause of mortality in India and abroad. Various risk scores have been formulated to estimate CVD risk. The preferred biomarker for the detection of myocardial cell necrosis is cardiac troponin. Highly sensitive troponin assays are now available. Computed tomography coronary angiogram (CT-CAG) is the standard noninvasive modality to identify as well as exclude coronary artery disease (CAD). Our study aims to correlate high-sensitivity troponin I (hs-cTnI) and the QRESEARCH cardiovascular (CV) risk algorithm (QRISK3) score against CT-CAG and determine whether, by using these data, we can detect or rule out CAD accurately by noninvasive means alone.

Materials And Methods: We evaluated 100 subjects who presented with chest pain (primary prevention population) to the cardiology outpatient department. A detailed history was obtained, and blood investigations, including hs-cTnI, were conducted. The QRISK3 score was calculated, and CT-CAG was performed for all. Hs-cTnI >6 was considered significant. Those who had >50% diameter stenotic lesion(s) were deemed to have significant CAD.

Results: In our study with 100 subjects, 80 had hs-cTnI <6, and 20 subjects had hs-cTnI >6. The QRISK3 score did not show any statistical correlation with hs-cTnI. The hs-cTnI levels were compared with CT-CAG results and found that 80% of subjects with elevated hs-cTnI had CAD.

Conclusion: A strong correlation between elevated hs-cTnI levels and CAD by CT-CAG was established by our study. The early detection of CAD will prompt early management and delay further progression of the disease.