High-sensitivity cardiac troponins (hs-cTn) ), a specific intracellular enzyme of myocardial cells, is suggestive of myocardial cell injury. Elevation of hs-cTn is associated with coronary artery disease (CAD). We sought to explore the relation between hs-cTn and subclinical arteriosclerosis using coronary artery calcification (CAC) scoring, a known surrogate of arteriosclerosis, among people living with human immunodeficiency virus (PLHIV) older than 50 years.
This was a cross-sectional study among 338 PLHIV aged > 50 years on ART without evidence of CAD from Thailand. Non-contrast cardiac computer tomography (CT) for CAC and blood sampling for serum hs-cTn were assessed on the same day. Relationship between the CAC score(Agatston score) and serum hs-cTn levels was analysed using Spearman correlation and logistic regression models.
The majority of participants were male (62%) with the median age of 54 years. The median duration of ART was 16 (IQR 13-19) years. The median CD4 cell count was 614 cell/mm3, and 98% had HIV RNA < 50 copies/ml. Of all, 94% had hs-cTnI concentration above the limit of detection (1.9 pg/ml) with a median of 3.7 (IQR 2.7 to 5.2) pg/ml while 85% of them had hs-cTnT concentration above the limit of detection (3 pg/ml) with a median of 5.5 (IQR 3.8 to 8.7) pg/ml. Almost half of the participants had CAC>0 and 16% had CAC ? 100. Both hs-cTn concentrations were positively correlated with the Agatston score with the correlation coefficient of 0.28 and 0.27 (p<0.001) for hs-cTnI and hs-cTnT, respectively. In multivariate logistic regression analysis, the serum hs-cTnI level was independently associated with an increased odd of having Agatston score?100 (OR 2.83; 95% CI, 1.69-4.75, p=<0.001).
Among the well-controlled HIV-infected aging Asians without established CV disease, the hs-cTnI levels were correlated with subclinical coronary atherosclerosis, measured with CAC. Hs-cTnI may be a potential biomarker to detect CVD early among older PLHIV. Clinical significant of hs-cTnI and CAC > 100 with long-term adverse CV outcomes needs to be prospectively evaluated.