PLoS ONE (Jan 2019)

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

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

DOI
https://doi.org/10.1371/journal.pone.0222230
Journal volume & issue
Vol. 14, no. 9
p. e0222230

Abstract

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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.