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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
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.
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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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