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Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina
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...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733469/ https://www.ncbi.nlm.nih.gov/pubmed/31498833 http://dx.doi.org/10.1371/journal.pone.0222230 |
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author | Lanza, Gaetano Antonio Mencarelli, Erica Melita, Veronica Tota, Antonio Gabrielli, Maurizio Sarullo, Filippo Cordischi, Chiara Potenza, Annalisa Cardone, Silvia De Vita, Antonio Bisignani, Antonio Manfredonia, Laura Caccamo, Giuseppa Vitale, Giuseppe Baroni, Silvia Antenucci, Mirca Crea, Filippo Franceschi, Francesco |
author_facet | Lanza, Gaetano Antonio Mencarelli, Erica Melita, Veronica Tota, Antonio Gabrielli, Maurizio Sarullo, Filippo Cordischi, Chiara Potenza, Annalisa Cardone, Silvia De Vita, Antonio Bisignani, Antonio Manfredonia, Laura Caccamo, Giuseppa Vitale, Giuseppe Baroni, Silvia Antenucci, Mirca Crea, Filippo Franceschi, Francesco |
author_sort | Lanza, Gaetano Antonio |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6733469 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-67334692019-09-20 Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina Lanza, Gaetano Antonio Mencarelli, Erica Melita, Veronica Tota, Antonio Gabrielli, Maurizio Sarullo, Filippo Cordischi, Chiara Potenza, Annalisa Cardone, Silvia De Vita, Antonio Bisignani, Antonio Manfredonia, Laura Caccamo, Giuseppa Vitale, Giuseppe Baroni, Silvia Antenucci, Mirca Crea, Filippo Franceschi, Francesco PLoS One Research Article 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. Public Library of Science 2019-09-09 /pmc/articles/PMC6733469/ /pubmed/31498833 http://dx.doi.org/10.1371/journal.pone.0222230 Text en © 2019 Lanza et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Lanza, Gaetano Antonio Mencarelli, Erica Melita, Veronica Tota, Antonio Gabrielli, Maurizio Sarullo, Filippo Cordischi, Chiara Potenza, Annalisa Cardone, Silvia De Vita, Antonio Bisignani, Antonio Manfredonia, Laura Caccamo, Giuseppa Vitale, Giuseppe Baroni, Silvia Antenucci, Mirca Crea, Filippo Franceschi, Francesco Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina |
title | Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina |
title_full | Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina |
title_fullStr | Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina |
title_full_unstemmed | Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina |
title_short | Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina |
title_sort | post-exercise high-sensitivity troponin t levels in patients with suspected unstable angina |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733469/ https://www.ncbi.nlm.nih.gov/pubmed/31498833 http://dx.doi.org/10.1371/journal.pone.0222230 |
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