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Updated: Dec 20, 2025

Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
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Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training

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Elevated troponin levels in patients with atrial tachyarrhythmias

Zach Rozenbaum1, Orly Sapir1, Philippe Taieb1

  • 1Department of Cardiology, Tel Aviv Medical Center and Sackler School of Medicine.

Coronary Artery Disease
|May 27, 2020
PubMed

Insights

Elevated troponin levels are not reliable indicators of obstructive coronary artery disease (CAD) in patients with atrial tachyarrhythmias. Risk stratification should consider troponin levels, diabetes, and prior ischemic heart disease.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Diagnostic Imaging

Background:

  • Elevated troponin levels are commonly observed in patients with atrial tachyarrhythmias, but their significance in diagnosing obstructive coronary artery disease (CAD) remains unclear.
  • Atrial tachyarrhythmias can independently increase troponin levels, potentially confounding the diagnosis of acute myocardial infarction.

Purpose of the Study:

  • To evaluate the discriminative ability of troponin in identifying obstructive CAD among patients presenting with atrial tachyarrhythmias.
  • To compare the prevalence of obstructive CAD in patients with and without atrial tachyarrhythmias who have elevated troponin levels.

Main Methods:

  • Retrospective analysis of 318 patients undergoing coronary angiography.
  • Comparison between 159 patients with atrial tachyarrhythmias and elevated troponin and 159 matched controls without arrhythmias.
  • Inclusion criteria: suspected non-ST elevation myocardial infarction and elevated serum troponin levels.

Main Results:

  • Obstructive CAD was significantly less prevalent in patients with atrial tachyarrhythmias (39%) compared to controls (85.5%) (P < 0.001).
  • Multivariable analysis identified diabetes mellitus (OR 2.7), prior ischemic heart disease (OR 4.48), and troponin level (OR 3.18 per 1000 ng/L increment) as predictors of obstructive CAD in patients with atrial tachyarrhythmias.

Conclusions:

  • Elevated troponin is not a reliable marker for obstructive CAD in patients with atrial tachyarrhythmias.
  • Risk stratification for obstructive CAD in this population should incorporate the degree of troponin elevation, presence of diabetes mellitus, and history of ischemic heart disease.
Abstract

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