Publication: High-sensitivity cardiac troponin T in stable patients undergoing pharmacological stress testing
Issued Date
2015-05-01
Resource Type
ISSN
19328737
01609289
01609289
Other identifier(s)
2-s2.0-84929706688
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Cardiology. Vol.38, No.5 (2015), 293-299
Suggested Citation
Nattawut Wongpraparut, Sudarat Piyophirapong, Adisak Maneesai, Kosit Sribhen, Rungroj Krittayaphong, Rungtiwa Pongakasira, Harvey D. White High-sensitivity cardiac troponin T in stable patients undergoing pharmacological stress testing. Clinical Cardiology. Vol.38, No.5 (2015), 293-299. doi:10.1002/clc.22392 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36449
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
High-sensitivity cardiac troponin T in stable patients undergoing pharmacological stress testing
Other Contributor(s)
Abstract
© 2015 Wiley Periodicals, Inc. 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.