High-sensitivity cardiac troponin T in stable patients undergoing pharmacological stress testing.
Clin Cardiol
; 38(5): 293-9, 2015 May.
Article
em En
| MEDLINE
| ID: mdl-25955350
ABSTRACT
BACKGROUND:
Acute changes in high-sensitivity troponin T (hs-TnT) are induced by myocardial ischemia during exercise stress testing, but there are no reports of pharmacological stress testing.HYPOTHESIS:
The pattern of troponin release by myocardial ischemia-induced pharmacological stress testing differs according to the ischemic burden in stable patients.METHODS:
In total, 250 patients with suspected coronary artery disease underwent pharmacological stress magnetic resonance imaging (MRI). The amount and degree of myocardial ischemia on MRI and ischemic outcomes at 6 months were determined. hs-TnT levels were measured at baseline and 1 and 3 hours after testing. The 6-month clinical outcome was prespecified.RESULTS:
Fifty-one patients had moderate to severe myocardial ischemia (group A), and 199 patients had no or mild myocardial ischemia (group B). hs-TnT levels were significantly higher in group A than B at baseline (11 vs 8 pg/mL, P = 0.016) and at 1 hour (12 vs 8 pg/mL, P = 0.009) and 3 hours after testing (12 vs 9 pg/mL, P = 0.012). Baseline hs-TnT levels of ≥14 pg/mL showed a 43% sensitivity and 77% specificity in predicting moderate to severe ischemia by MRI (P = 0.03; area under the curve 0.608, P = 0.017). Patients administered dobutamine had a higher acute change in hs-TnT levels 3 hours after testing than did those administered adenosine (21 vs 0 pg/mL, P < 0.001). There was a trend toward a higher incidence of myocardial infarction in patients with baseline hs-TnT levels of ≥14 pg/mL.CONCLUSIONS:
hs-TnT levels are significantly higher in patients with moderate to severe than no or mild myocardial ischemia.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
/
Isquemia Miocárdica
/
Troponina T
/
Teste de Esforço
/
Imagem de Perfusão do Miocárdio
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Cardiol
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Tailândia