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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
Summary
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.
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