# Association of Cardiovascular Biomarkers With Cardiac Allograft Vasculopathy and Atherosclerotic Coronary Artery Disease

## TL;DR

This study compares cardiovascular biomarkers in heart transplant patients with CAV and non-transplant patients with CAD, finding distinct biomarker profiles for each condition.

## Contribution

The study identifies unique associations of biomarkers with CAV and CAD, offering insights into their differing pathophysiology.

## Key findings

- HsTnI/T and NT-proBNP were significantly associated with CAV in transplant patients.
- HsTnT and hsCRP were significantly associated with CAD in non-transplant patients.
- Distinct biomarker profiles were observed between CAV and CAD.

## Abstract

Background: Cardiac allograft vasculopathy (CAV) remains a barrier to long‐term survival after heart transplantation. Little is known about cardiovascular biomarkers in CAV and how they compare to biomarkers in atherosclerotic coronary artery disease (CAD).

Purpose: This study addresses these gaps by investigating the associations of high‐sensitivity troponin I and T (hsTnI/T), N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity C‐reactive protein (hsCRP) with CAV and CAD.

Methods: Posttransplant patients undergoing angiography were matched 1:2 with nontransplant patients by age, sex, hypertension, BMI and angiographic severity of CAV and CAD. Disease severity was classified using the International Society for Heart and Lung Transplantation.

Results: Sixty‐three transplant and 126 matched nontransplant patients (median age 55.9 years, 5.8 years posttransplant, 8.5% female) were analyzed. Among transplant patients, 17.5% had mild, 7.9% moderate, 7.9% severe, and 66.7% no CAV. HsTnI/T (OR per SD = 2.21/2.38, CI = 1.17–4.66/1.21–5.69, p = 0.022/0.026) and NT‐proBNP (OR per SD = 2.86, 95% CI 1.50–6.39, p = 0.004) were significantly associated with CAV. While hsTnT (OR per SD = 1.60, 95% CI 1.06–2.52, p = 0.030) and hsCRP (OR per SD = 1.61, 95% CI 1.08–2.47, p = 0.023) were significantly associated with CAD.

Conclusion: Distinct biomarker profiles were observed: HsTnI, hsTnT, and NT‐proBNP showed associations with CAV, while hsTnT and hsCRP were associated with CAD.