Predictors of Stress-Delta High-Sensitivity Troponin T in Emergency Department Patients Undergoing Stress Testing.

Autor:	White EJ; Department of Emergency Medicine, Duke University School of Medicine, Durham, USA., Susman SJ; Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, USA., Bouffler A; Department of Emergency Medicine, Duke University School of Medicine, Durham, USA., Leahy JC; Department of Emergency Medicine, Duke University School of Medicine, Durham, USA., Griffin SM; Department of Emergency Medicine, Duke University School of Medicine, Durham, USA., Christenson R; Department of Pathology, University of Maryland, Baltimore, USA., Newby LK; Department of Medicine, Duke University School of Medicine, Durham, USA., Gordee A; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA., Kuchibhatla M; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA., Limkakeng AT; Department of Emergency Medicine, Duke University School of Medicine, Durham, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2022 Sep 26; Vol. 14 (9), pp. e29601. Date of Electronic Publication: 2022 Sep 26 (Print Publication: 2022).
DOI:	10.7759/cureus.29601
Abstrakt:	Background and objective Elevations in high-sensitivity troponin T (hs-TnT) are frequently observed following extreme physical exercise. In light of this, we sought to determine whether specific clinical characteristics are associated with this phenomenon in patients undergoing cardiac exercise tolerance testing (ETT). Methods We conducted a retrospective analysis of a prospectively collected biospecimen repository of 257 patients undergoing a stress echocardiogram for possible acute coronary syndrome (ACS). Ischemic electrocardiogram (ECG) changes during ETT and the presence or absence of ischemia on imaging were determined by a board-licensed cardiologist. N-terminal pro-brain natriuretic peptide (NT-proBNP) and hs-TnT assays were obtained immediately before and two hours following ETT. We developed linear regression models including several clinical characteristics to predict two-hour stress-delta hs-TnT. Variable selection was performed using the least absolute shrinkage and selection operator (LASSO). Results The mean age of the patients was 52 years [standard deviation (SD): 11.4]; 125 (48.6%) of them were men, and 88 (34.2%) were African-American. Twenty-two patients (8.6%) had ischemia evident on echocardiography, and 31 (12.1%) had ischemic ECG changes during exercise. The mean baseline hs-TnT was 5.6 ng/L (SD: 6.4) and the mean two-hour hs-TnT was 7.1 ng/L (SD: 10.2). Age and ischemic ECG changes were associated with two-hour stress-delta hs-TnT values. Conclusions Based on our findings, ischemic changes in stress ECG and age were associated with an increase in hs-TnT levels following exercise during a stress echo. Competing Interests: The authors have declared financial relationships, which are detailed in the next section. (Copyright © 2022, White et al.)
Databáze:	MEDLINE
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