The role of peak troponin in patients with a working diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA)
| Autor: | Chris B Lawton, Giovanni Biglino, Kate Liang, M G L Williams, L Spagnoli, Amardeep Ghosh Dastidar, Thomas W Johnson, E Fiori, E De Garate, C Bucciarelli-Ducci |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Troponin T biology business.industry Infarction General Medicine Working diagnosis medicine.disease Troponin Coronary arteries medicine.anatomical_structure Linear gingival erythema Internal medicine medicine Cardiology biology.protein Radiology Nuclear Medicine and imaging In patient Myocardial infarction Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal - Cardiovascular Imaging. 22 |
| ISSN: | 2047-2412 2047-2404 |
| Popis: | Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Rosetrees Trust James Tudor Foundation Background 6-10% of patients who present with an acute coronary syndrome have a myocardial infarction with non-obstructive coronary arteries (MINOCA). Troponin T predicts infarct size and outcomes in patients with ST-elevation myocardial infarction. The value of peak troponin T in patients with a working diagnosis of MINOCA is not well understood. Purpose The aim of this study is to investigate the diagnostic and prognostic role of troponin in patients with MINOCA. Methods Consecutive patients with a working diagnosis of MINOCA (n = 719) from a single tertiary centre who underwent comprehensive cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) were followed prospectively. The primary endpoint was all-cause mortality. Results Peak troponin T ≥211 ng/L and time to CMR of ≤17 days have a positive predictive value of 94% for being able to make a diagnosis on CMR. If the scan was performed in ≤17 days the diagnostic yield was still 75% even in the lowest troponin decile, but this was 59% if performed after 17 days. Each increase in troponin decile increases the mean diagnostic yield of the CMR by 3.7% (p Conclusions Peak troponin T and time to CMR can be used by cardiologists to determine the likelihood of making a diagnosis using CMR. A higher troponin quartile is associated with lower mortality. |
| Databáze: | OpenAIRE |
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