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

Lukas Köster; Jessica Weimann; Alexander Bernhard; Benjamin Bay; Christopher M Blaum; Thiess Lorenz; Tanja Zeller; Christoph Waldeyer; Hermann Reichenspurner; Paulus Kirchhof; Stefan Blankenberg; Christina Magnussen; Fabian J Brunner

doi:10.1111/ctr.70195

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

Lukas Köster, Jessica Weimann, Alexander Bernhard, Benjamin Bay, Christopher M Blaum, Thiess Lorenz, Tanja Zeller, Christoph Waldeyer, Hermann Reichenspurner, Paulus Kirchhof, Stefan Blankenberg, Christina Magnussen, Fabian J Brunner

Institute of Cardiogenetics

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.

Original language	English
Journal	Clinical Transplantation
Volume	39
Issue number	6
Pages (from-to)	e70195
ISSN	0902-0063
DOIs	https://doi.org/10.1111/ctr.70195
Publication status	Published - 06.2025

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Köster, L., Weimann, J., Bernhard, A., Bay, B., Blaum, C. M., Lorenz, T., Zeller, T., Waldeyer, C., Reichenspurner, H., Kirchhof, P., Blankenberg, S., Magnussen, C., & Brunner, F. J. (2025). Association of Cardiovascular Biomarkers With Cardiac Allograft Vasculopathy and Atherosclerotic Coronary Artery Disease. Clinical Transplantation, 39(6), e70195. https://doi.org/10.1111/ctr.70195

@article{5039438e47524f2b839874aee9324472,

title = "Association of Cardiovascular Biomarkers With Cardiac Allograft Vasculopathy and Atherosclerotic Coronary Artery Disease",

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.",

author = "Lukas K{\"o}ster and Jessica Weimann and Alexander Bernhard and Benjamin Bay and Blaum, \{Christopher M\} and Thiess Lorenz and Tanja Zeller and Christoph Waldeyer and Hermann Reichenspurner and Paulus Kirchhof and Stefan Blankenberg and Christina Magnussen and Brunner, \{Fabian J\}",

note = "{\textcopyright} 2025 The Author(s). Clinical Transplantation published by Wiley Periodicals LLC.",

year = "2025",

month = jun,

doi = "10.1111/ctr.70195",

language = "English",

volume = "39",

pages = "e70195",

journal = "Clinical Transplantation",

issn = "0902-0063",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "6",

}

Köster, L, Weimann, J, Bernhard, A, Bay, B, Blaum, CM, Lorenz, T, Zeller, T, Waldeyer, C, Reichenspurner, H, Kirchhof, P, Blankenberg, S, Magnussen, C & Brunner, FJ 2025, 'Association of Cardiovascular Biomarkers With Cardiac Allograft Vasculopathy and Atherosclerotic Coronary Artery Disease', Clinical Transplantation, vol. 39, no. 6, pp. e70195. https://doi.org/10.1111/ctr.70195

TY - JOUR

T1 - Association of Cardiovascular Biomarkers With Cardiac Allograft Vasculopathy and Atherosclerotic Coronary Artery Disease

AU - Köster, Lukas

AU - Weimann, Jessica

AU - Bernhard, Alexander

AU - Bay, Benjamin

AU - Blaum, Christopher M

AU - Lorenz, Thiess

AU - Zeller, Tanja

AU - Waldeyer, Christoph

AU - Reichenspurner, Hermann

AU - Kirchhof, Paulus

AU - Blankenberg, Stefan

AU - Magnussen, Christina

AU - Brunner, Fabian J

PY - 2025/6

Y1 - 2025/6

N2 - 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.

AB - 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.

U2 - 10.1111/ctr.70195

DO - 10.1111/ctr.70195

M3 - Journal articles

C2 - 40485380

SN - 0902-0063

VL - 39

SP - e70195

JO - Clinical Transplantation

JF - Clinical Transplantation

IS - 6

ER -

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

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