Clinical Implications of High-Sensitivity Troponin Elevation Levels in Non-ST-Segment Elevation Myocardial Infarction Patients: Beyond Diagnostics.
Constanza BravoGeovanna VizcarraAntonia SánchezFrancisca CárdenasJuan Pablo CanalesHéctor UgaldeAlfredo Parra-LucaresPublished in: Diagnostics (Basel, Switzerland) (2024)
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.
Keyphrases
- acute heart failure
- heart failure
- st segment elevation myocardial infarction
- end stage renal disease
- metabolic syndrome
- weight loss
- type diabetes
- percutaneous coronary intervention
- ejection fraction
- chronic kidney disease
- newly diagnosed
- coronary artery disease
- prognostic factors
- insulin resistance
- coronary artery
- bariatric surgery
- weight gain
- early onset
- obese patients
- big data
- machine learning
- transcatheter aortic valve replacement
- drug induced