High-sensitive cardiac Troponin T and exercise stress test for evaluation of angiographically significant coronary disease.
Int J Cardiol
; 287: 1-6, 2019 07 15.
Article
in En
| MEDLINE
| ID: mdl-31006595
ABSTRACT
BACKGROUND:
Exercise stress test (EST) has a moderate precision for diagnosis of CAD and could potentially obtain improved accuracy if adding a reliable cardiac biomarker to the test.OBJECTIVE:
We aimed to investigate resting levels and change in hs-cTnT during EST in patients with and without angiographically significant CAD. Moreover, we intended to explore the additive value of hs-cTnT to EST results in diagnosis of stable CAD. We hypothesized that hs-cTnT would be higher in CAD patients and increase diagnostic precision of EST.METHOD:
Patients presenting with symptoms of stable CAD, performed a maximal EST on a bicycle ergometer. Venous blood samples were taken at rest and within 5â¯min post-exercise. All patients underwent coronary angiography. Significant CAD was defined as having ≥75% stenosis in one or more segments of the coronary arteries.RESULTS:
Out of the 297 participants, significant CAD was found in 111 (37%) patients. Patients with significant CAD compared to without, had higher resting levels of hs-cTnT (median 8.1 vs 5.0â¯ng/L) and no significant difference in exercise-induced change (median 0.5 vs 0.3â¯ng/L), pâ¯<â¯0.001 and pâ¯=â¯0.086 respectively. Combined resting hs-cTnT with EST had higher predictive value for significant CAD than EST alone, AUCâ¯=â¯0.751 vs. AUCâ¯=â¯0.637. In an adjusted multivariable regression analysis, resting hs-cTnT >6.0â¯ng/L was predictive for having significant CAD, OR 2.55 (CI 95% 1.40, 4.65 pâ¯=â¯0.002).CONCLUSION:
In patients with suspected stable CAD, hs-cTnT has a predictive value alone, as well as added to a diagnostic EST for CAD.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Coronary Angiography
/
Troponin T
/
Exercise Test
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Int J Cardiol
Year:
2019
Document type:
Article