Biomarkers for Non-Invasive Stratification of Coronary Artery Disease and Prognostic Impact on Long-Term Survival in Patients with Stable Coronary Heart Disease

Jeffrey Netto; Andrej Teren; Ralph Burkhardt; Anja Willenberg; Frank Beutner; Sylvia Henger; Gerhard Schuler; Holger Thiele; Berend Isermann; Joachim Thiery; Markus Scholz; Thorsten Kaiser

doi:10.3390/nu14163433

Biomarkers for Non-Invasive Stratification of Coronary Artery Disease and Prognostic Impact on Long-Term Survival in Patients with Stable Coronary Heart Disease

Nutrients. 2022 Aug 20;14(16):3433. doi: 10.3390/nu14163433.

Authors

Jeffrey Netto^{1

2}, Andrej Teren^{1

3}, Ralph Burkhardt^{1

4}, Anja Willenberg^{1

2}, Frank Beutner^{1

5}, Sylvia Henger^{1

6}, Gerhard Schuler^{1

5}, Holger Thiele^{1

5}, Berend Isermann^{1

2}, Joachim Thiery^{1

7}, Markus Scholz^{1

6}, Thorsten Kaiser^{1

8}

Affiliations

¹ Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, 04109 Leipzig, Germany.
² Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, 04103 Leipzig, Germany.
³ Department of Cardiology and Intensive Care Medicine, University Hospital OWL, Campus Klinikum Bielefeld, 33604 Bielefeld, Germany.
⁴ Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, 93053 Regensburg, Germany.
⁵ Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, 04109 Leipzig, Germany.
⁶ Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04109 Leipzig, Germany.
⁷ Faculty of Medical, Christian-Albrechts-Unversity Kiel, 24105 Kiel, Germany.
⁸ Institute for Laboratory Medicine, Microbiology and Pathobiochemistry, University Hospital Ostwestfalen-Lippe (UK-OWL), Campus Klinikum Lippe, Bielefeld University, 33615 Bielefeld, Germany.

Abstract

Knowledge about cardiac and inflammatory biomarkers in patients with stable coronary artery disease (CAD) is limited. To address this, we analyzed 3072 patients (36% female) with a median follow-up of 10 years in the Leipzig LIFE Heart Study with suspected CAD with coronary angiography. Selected biomarkers included troponin T (hsTNT), N-terminal pro B-type natriuretic peptide (NT-proBNP), copeptin, C-reactive protein (hsCRP), and interleukin-6 (IL-6). Patients were stratified by CAD severity: CAD0 (no sclerosis), CAD1 (non-obstructive, i.e., stenosis < 50%), and CAD2 (≥one stenosis ≥ 50%). Group comparison (GC) included GC1: CAD0 + 1 vs. CAD2; GC2: CAD0 vs. CAD1 + 2. CAD0, CAD1, and CAD2 were apparent in 1271, 631, and 1170 patients, respectively. Adjusted for classical risk factors, hs-cTnT, NT-proBNP, and IL-6 differed significantly in both GC and hsCRP only in GC2. After multivariate analysis, hs-cTnT, NT-proBNP, and IL-6 remained significant in GC1. In GC2, hs-cTnT (p < 0.001) and copeptin (p = 0.014) reached significance. Ten-year survival in groups CAD0, CAD1, and CAD2 was 88.3%, 77.3%, and 72.4%. Incorporation of hs-cTnT, NT-proBNP, copeptin, and IL-6 improved risk prediction (p < 0.001). The studied cardiac and inflammatory biomarkers enable fast and precise non-invasive identification of mortality risk in CAD patients, allowing the tailoring of primary and secondary CAD prevention.

Keywords: biomarkers; long-term survival; stable coronary artery disease (CAD); troponin T.

MeSH terms

Biomarkers
C-Reactive Protein
Constriction, Pathologic
Coronary Artery Disease*
Female
Humans
Interleukin-6
Male
Natriuretic Peptide, Brain
Peptide Fragments
Prognosis

Substances

Biomarkers
Interleukin-6
Peptide Fragments
Natriuretic Peptide, Brain
C-Reactive Protein

Grants and funding

This publication is supported by the Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig. LIFE is funded by the European Union, the European Regional Development Fund (ERDF), and the Free State of Saxony within the Framework of Excellence initiative. The copeptin tests were supported by Thermo Fisher. The tests for hs-cTnT, NT-pro-BNP, hsCRP, and IL-6 were supported by Roche Diagnostics. Relationships with the industry: none.