학술논문
Clinical Implications of High-Sensitivity Troponin Elevation Levels in Non-ST-Segment Elevation Myocardial Infarction Patients: Beyond Diagnostics.
Document Type
Academic Journal
Author
Bravo C; Cardiovascular Department, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile.; Vizcarra G; Cardiovascular Department, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile.; Sánchez A; Faculty of Medicine, School of Medicine, Universidad de Chile, Santiago 8380456, Chile.; Cárdenas F; Faculty of Medicine, School of Medicine, Universidad de Chile, Santiago 8380456, Chile.; Canales JP; Faculty of Medicine, School of Medicine, Universidad de Chile, Santiago 8380456, Chile.; Ugalde H; Cardiovascular Department, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile.; Parra-Lucares A; Cardiovascular Department, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile.; Cardiovascular Research Unit, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101658402 Publication Model: Electronic Cited Medium: Print ISSN: 2075-4418 (Print) Linking ISSN: 20754418 NLM ISO Abbreviation: Diagnostics (Basel) Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2075-4418
Abstract
Standard troponin has long been pivotal in diagnosing coronary syndrome, especially Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). The recent introduction of high-sensitivity troponin (hs-cTnI) has elevated it to the gold standard. Yet, its nuanced role in predicting angiographic lesions and clinical outcomes, notably in specific populations like obesity, remains underexplored. Aim : To evaluate the association between hs-cTnI magnitude in NSTEMI patients and angiographic findings, progression to acute heart failure, and its performance in obesity. Methods : Retrospective study of 208 NSTEMI patients at a large university center (2020-2023). Hs-cTnI values were assessed for angiographic severity, acute heart failure, and characteristics in the obese population. Data collected and diagnostic performance were evaluated using manufacturer-specified cutoffs. Results : 97.12% of patients had a single culprit vessel. Hs-cTnI elevation correlated with angiographic stenosis severity. Performance for detecting severe coronary disease was low, with no improvement using a higher cutoff. No association was found between hs-cTnI and the culprit vessel location. Hs-cTnI did not predict acute heart failure progression. In the obese population, hs-cTnI levels were higher, but acute heart failure occurred less frequently than in non-obese counterparts. Conclusions : In NSTEMI, hs-cTnI elevation is associated with significant stenosis, but not with location or acute heart failure. Obesity correlates with higher hs-cTnI levels but a reduced risk of acute heart failure during NSTEMI.