Journal Article

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

Potenza, Annalisa, Cardone, Silvia, Lanza, Gaetano Antonio, Vitale, Giuseppe, Manfredonia, Laura, Antenucci, Mirca, Caccamo, Giuseppa, De Vita, Antonio, Crea, Filippo, Tota, Antonio, Bisignani, Antonio, Baroni, Silvia, Gabrielli, Maurizio, Mencarelli, Erica, Cordischi, Chiara, Sarullo, Filippo, Melita, Veronica, Franceschi, Francesco

2019

Overview

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. 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%). 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. 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.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Angina / Angina pectoris / Angina, Unstable - blood / Angiography / Biology and Life Sciences / Biomarkers - blood / Blood levels / Calcium-binding protein / Cardiovascular disease / Chest / Coronary Angiography / Coronary artery / Coronary artery disease / Coronary Artery Disease - blood / Coronary Artery Disease - diagnosis / Coronary heart disease / Diabetes / Diagnosis / Electrocardiography / Emergency medical care / Emergency medical services / Exercise / Exercise - physiology / Exercise equipment / Exercise Test / Female / Health aspects / Health risk assessment / Heart attack / Heart diseases / Heart rate / Humans / Male / Medical research / Medicine and Health Sciences / Middle Aged / Pain / Physical training / Regression analysis / Research and Analysis Methods / Risk factors / Serum levels / Signs and symptoms / Treadmills / Troponin / Troponin T / Troponin T - blood / Unstable angina