The Clinical Significance of Elevated Troponin in Patients with Acute Coronary Syndrome with Normal Electrocardiogram.
10.4070/kcj.2003.33.5.385
- Author:
Sang Yeob LIM
1
;
Myung Ho JEONG
;
Eun Hee BAE
;
Doo Sun SHIM
;
Sang Hyun LEE
;
Weon KIM
;
Ju Han KIM
;
Ok Young PARK
;
Woo Suk PARK
;
Young Keun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Soon Pal SUH
;
Byoung Hee AHN
;
Sang Hyung KIM
;
Jung Chaee KANG
Author Information
1. The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Coronary disease;
Electrocardiography;
Angina, unstable;
Myocardial infarction;
Coronary stenosis;
Troponin;
Prognosis
- MeSH:
Acute Coronary Syndrome*;
Angina, Unstable;
Constriction, Pathologic;
Coronary Disease;
Coronary Stenosis;
Early Diagnosis;
Electrocardiography*;
Follow-Up Studies;
Humans;
Myocardial Infarction;
Phenobarbital;
Prognosis;
Risk Factors;
Stroke Volume;
Troponin*
- From:Korean Circulation Journal
2003;33(5):385-392
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The level of cardiac specific troponin (cTn) may be important in patients with acute coronary syndrome (ACS), but with normal electrocardiography (ECG). SUBJECTS AND METHODS: Three hundred and nineteen patients (61+/-11 years, M:F=212:107), with ACS and normal ECG, who underwent a diagnostic coronary angiogram (CAG), between July 2000 and June 2001, were analyzed according to their cTn level. The clinical characteristics, initial CAG findings and major adverse cardiac events (MACE), during a one-year clinical follow-up, were compared between positive and negative cTn groups. RESULTS: Of the enrolled patients, 191 had a negative cTn (group A, 61+/-10 years, M:F=131:60), and 128 a positive cTn (group B, 60+/-11 years, M:F=81:47), and 176 (55.2%) were shown to have significant coronary artery stenosis on CAG. There were no significant differences in risk factors between the two groups. The mean left ventricular ejection fraction was 64+/-9%, and was lower in group B than in group A (59+/-10% vs. 67+/-7%, p<0.05). cTn positivity was associated with the percentage of significant coronary artery stenosis present (88% vs. 32%, p<0.05), a smaller minimal luminal diameter (1.09+/-0.44 mm vs. 2.68+/-0.33 mm, p<0.05) and a larger diameter of stenosis (68+/-6% vs. 44+/-6%, p<0.05). A multi-vessel lesion was more common in group B than in group A (58.3% vs. 30.3%, p<0.05). During the one-year follow-up period, 36 patients developed MACE, resulting in 3 deaths, 7 acute myocardial infarctions and 34 patients with restenosis. MACE was observed in 9 patients of group A and in 27 of group B (4.7% vs. 21.1%, p<0.05). CONCLUSION: The troponin levels are valuable for the early diagnosis, and prediction of the long-term prognosis, in patients with ACS and a normal ECG.
