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Which high-sensitivity troponin variable best characterizes infarct size and microvascular obstruction?

Mathieu Schaaf1, Fabien Huet2, Mariama Akodad2

  • 1Service d'explorations fonctionnelles cardiovasculaires, cardiology division, hôpital Louis-Pradel, CHU de Lyon, 69500 Bron, France.

Archives of Cardiovascular Diseases
|February 20, 2019
PubMed

Insights

High-sensitivity troponin T (hs-TnT) second peak (SP) best characterizes myocardial infarction size and microvascular obstruction (MVO). This finding aids in understanding troponin kinetics for ST-elevation myocardial infarction (STEMI) patient evaluation.

Area of Science:

  • Cardiology
  • Biomarker analysis
  • Cardiac imaging

Background:

  • High-sensitivity troponin (hs-Tn) levels correlate with infarct size.
  • Limited understanding exists regarding troponin kinetics and their relationship with infarct characteristics like microvascular obstruction (MVO).

Purpose of the Study:

  • To determine which high-sensitivity troponin (hs-Tn) assay best characterizes myocardial infarction (MI).
  • To investigate the correlation between troponin kinetics and infarct size (IS) and MVO.

Main Methods:

  • Evaluated kinetics of hs-TnT, hs-TnI, and s-TnI in 29 STEMI patients.
  • Compared area under curves (AUC), first peak (FP), and second peak (SP) of hs-TnT with IS and MVO using cardiac MRI.

Main Results:

  • The second peak (SP) of hs-TnT showed the strongest correlation with infarct size (IS) (r=0.9) and MVO (r=0.84) compared to other troponin assays.
  • While hs-TnT achieved the best AUC (0.95), no significant statistical differences were found compared to other hs-Tn assays' AUCs.

Conclusions:

  • The second peak (SP) of hs-TnT is the optimal biomarker for evaluating and characterizing infarct size.
  • Understanding troponin kinetics, particularly the SP of hs-TnT, improves the characterization of myocardial infarction and MVO.
Abstract

Keywords:
Acute myocardial infarctionCe-CMRHigh-sensitivity troponinIRM cardiaqueInfarct characterizationInfarctus du myocarde aiguMicrovascular obstructionObstruction micro-vasculaireTaille de nécroseTroponine sensible

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