Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
19
06
2019
accepted:
23
08
2019
entrez:
10
9
2019
pubmed:
10
9
2019
medline:
13
3
2020
Statut:
epublish
Résumé
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.
Sections du résumé
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.
Identifiants
pubmed: 31498833
doi: 10.1371/journal.pone.0222230
pii: PONE-D-19-17323
pmc: PMC6733469
doi:
Substances chimiques
Biomarkers
0
Troponin T
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0222230Déclaration de conflit d'intérêts
The authors declare that no competing interests exist.
Références
J Am Coll Cardiol. 2002 Oct 16;40(8):1531-40
pubmed: 12392846
Am Heart J. 1992 Jul;124(1):252-6
pubmed: 1615823
Clin Chem. 2008 Jul;54(7):1234-8
pubmed: 18593962
N Engl J Med. 2009 Aug 27;361(9):858-67
pubmed: 19710484
Clin Chim Acta. 2010 Mar;411(5-6):318-23
pubmed: 20036224
J Am Coll Cardiol. 2010 Jul 13;56(3):169-76
pubmed: 20620736
Eur Heart J. 2011 Feb;32(4):404-11
pubmed: 21169615
Echocardiography. 2011 Feb;28(2):219-22
pubmed: 21198823
J Am Coll Cardiol. 2011 Jun 14;57(24):2398-405
pubmed: 21658559
J Am Coll Cardiol. 2011 Jun 14;57(24):2406-8
pubmed: 21658560
Clin Sci (Lond). 2012 Jun;122(12):599-606
pubmed: 22239123
Clin Chem. 2012 Nov;58(11):1565-73
pubmed: 22997281
J Am Coll Cardiol. 2012 Dec 11;60(23):2427-63
pubmed: 23154053
PLoS One. 2013;8(4):e60163
pubmed: 23565198
J Am Coll Cardiol. 2014 Dec 23;64(24):e139-e228
pubmed: 25260718
Eur Heart J. 2016 Jan 14;37(3):267-315
pubmed: 26320110
Clin Biochem. 2016 Apr;49(6):419-420
pubmed: 26969798
JACC Cardiovasc Imaging. 2018 Apr;11(4):603-611
pubmed: 28330661
Eur Heart J Acute Cardiovasc Care. 2018 Sep;7(6):544-552
pubmed: 29064277
Clin Chim Acta. 2018 Apr;479:155-159
pubmed: 29366834
J Exerc Sci Fit. 2017 Dec;15(2):49-54
pubmed: 29541132
J Am Coll Cardiol. 2018 Apr 10;71(14):1540-1549
pubmed: 29622161
J Am Coll Cardiol. 2018 Oct 30;72(18):2231-2264
pubmed: 30153967