Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina


Autoři: Gaetano Antonio Lanza aff001;  Erica Mencarelli aff001;  Veronica Melita aff001;  Antonio Tota aff002;  Maurizio Gabrielli aff002;  Filippo Sarullo aff003;  Chiara Cordischi aff002;  Annalisa Potenza aff002;  Silvia Cardone aff002;  Antonio De Vita aff001;  Antonio Bisignani aff001;  Laura Manfredonia aff001;  Giuseppa Caccamo aff003;  Giuseppe Vitale aff003;  Silvia Baroni aff004;  Mirca Antenucci aff004;  Filippo Crea aff001;  Francesco Franceschi aff002
Působiště autorů: Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Department of Cardiovascular Disease, Roma, Italy aff001;  Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Department of Emergency Medicine, Roma, Italy aff002;  Ospedale Buccheri La Ferla, Cardiac Rehabilitation Unit, Palermo, Italy aff003;  Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Department of Clinical Chemistry, Roma, Italy aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222230

Souhrn

Background

Previous studies showed that troponin blood levels may increase after exercise. In this study we assessed whether, among patients admitted with suspected unstable angina, the increase in high-sensitive troponin T (hs-TnT) levels after exercise stress test (EST) might help identify those with obstructive coronary artery disease (CAD) and predict symptom recurrence during short term follow-up.

Methods

Maximal treadmill EST was performed in 69 consecutive patients admitted to the emergency room with a suspicion of unstable angina (acute chest pain but confirmed normal serum levels of cardiac troponins) was measured before and 4 hours after EST. Coronary angiography was performed in 22 patients (32.8%).

Results

hs-TnT increased after EST compared to baseline in the whole population (from 0.84±0.65 to 1.17±0.87 ng/dL, p<0.001). The increase was similar in patients with positive (n = 14) and negative (n = 55) EST (p = 0.72), and was also similar in patients with (n = 12) and without (n = 10) obstructive CAD at angiography (p = 0.91). The achievement of a heart rate at peak EST ≥85% of that predicted for age was the variable mainly associated with the post-EST hs-TnT increase at multivariable linear regression analysis (p = 0.005). The change after EST of hs-TnT did not predict the recurrence of symptoms or readmission for chest pain at 6-month follow-up.

Conclusions

Our data show that hs-TnT increased after EST in patients with suspected unstable angina, which seemed largely independent of most clinical and laboratory variables. Thus, hs-TnT assessed after EST does not seem to be helpful to identify patients with obstructive CAD in this kind of patients.

Klíčová slova:

Biology and life sciences – Biochemistry – Proteins – Cytoskeletal proteins – Troponin – Medicine and health sciences – Vascular medicine – Coronary heart disease – Angina – Ischemia – Cardiology – Cardiovascular medicine – Cardiovascular imaging – Angiography – Diagnostic medicine – Diagnostic radiology – Radiology and imaging – Endocrinology – Endocrine disorders – Metabolic disorders – Surgical and invasive medical procedures – Cardiovascular procedures – Angioplasty – Coronary angioplasty – Research and analysis methods – Imaging techniques – Bioassays and physiological analysis – Electrophysiological techniques – Cardiac electrophysiology – Electrocardiography


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PLOS One


2019 Číslo 9

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