Correlation of calcium score and stenosis degree with high sensitivity cardiac troponin I in coronary artery disease patients

Abstract

Background. Coronary artery disease (CAD) is a leading cause of mortality, often associated with myocardial fibrosis and acute coronary syndromes. Coronary artery calcium (CAC) scoring and high-sensitivity cardiac troponin I (hs-TnI) are valuable markers for cardiovascular risk assessment, yet their correlation with stenosis severity remains incompletely understood. Methods. This cross-sectional study analyzed secondary data from multislice computed tomography angiography (MSCTA) and hs-TnI tests of CAD patients in Makassar from January 2021 to August 2024. Correlation analysis between CAC score, stenosis severity, and hs-TnI levels was performed using Pearson’s or Spearman’s tests, with p < 0.05 considered significant. Results. Of 424 samples, 55 met inclusion criteria (20 acute CAD, 35 chronic CAD). The median hs-TnI level was higher in acute CAD (7.55 ng/L) than chronic CAD (3.00 ng/L). In acute CAD, CAC scores were most frequently minimal (30%), whereas chronic CAD had the highest proportion in the none calcification (40%). Regarding the degree of stenosis, category 3 was the most prevalent in the acute CAD group, observed in 25% (5 samples), while in chronic CAD, the most common stenosis degree was 0 group (31.4%). A significant correlation was observed between CAC score and hs-TnI (p = 0.043, r = 0.456) and between stenosis severity and hs-TnI (p = 0.046, r = 0.450). Additionally, CAC scores strongly correlated with stenosis severity (p = 0.002, r = 0.661). Conclusion. The observed correlation between calcium score, stenosis severity, and hs-TnI levels suggests a meaningful correlation between anatomical findings and myocardial injury in coronary artery disease. These parameters may complement each other in improving cardiovascular risk assessment and clinical evaluation.

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