Article Text

other Versions

PDF
Troponin-I concentration 72 hours after myocardial infarction correlates with infarct size and presence of microvascular obstruction
  1. John F Younger (jonnyfyounger{at}hotmail.com)
  1. Leeds University, United Kingdom
    1. Sven Plein
    1. Leeds University, United Kingdom
      1. Julian Barth
      1. Leeds General Infirmary, United Kingdom
        1. John P Ridgway
        1. Leeds University, United Kingdom
          1. Stephen G Ball
          1. Leeds University, United Kingdom
            1. John P Greenwood (j.greenwood{at}leeds.ac.uk)
            1. Leeds General Infirmary, United Kingdom

              Abstract

              Objectives The aim of this study was to use late gadolinium hyper-enhancement cardiac magnetic resonance (LGE-CMR) imaging to determine if a 72 hour troponin-I (72h-troponin-I) measurement would provide a more accurate estimation of infarct size and microvascular obstruction (MVO) than serial CK or early troponin-I values.

              Methods LGE-CMR was performed 3.7 ± 1.4 days after medical treatment for acute ST elevation or non ST elevation myocardial infarction. Infarct size and MVO were measured and correlated with serum troponin-I concentrations which were sampled at 12 hours and at 72 hours after admission, in addition to serial creatine kinase (CK) levels.

              Results Ninety-three patients, of whom 71 had received thrombolysis for ST elevation myocardial infarction, completed the CMR study. Peak CK, 12h-troponin-I, and 72h-troponin-I were related to infarct size by LGE-CMR (r=0.75, p<0.0001; r=0.56, p=0.0003; r=0.62, p<0.0001 respectively). Serum biomarkers demonstrated higher values in the group with MVO compared to those without MVO (Peak CK 3085 ± 1531 vs. 1471 ± 1135, p<0.001; 12h-troponin-I 58.3 ± 46.9 vs. 33.4 ± 40.0, p=0.13; 72h-troponin-I 11.5 ± 9.9 vs. 5.5 ± 4.6, p<0.005). The correlation between the extent of MVO and 12h-troponin-I was not significant (r=0.16), in contrast to the other serum biomarkers (peak CK r=0.44, p<0.0001; 72h-troponin-I r=0.46, p=0.0002).

              Conclusion A single measurement of 72h-troponin-I is similar to serial CK measurements in the estimation of both myocardial infarct size and extent of MVO and is superior to 12h-troponin-I measurements.

              Statistics from Altmetric.com

              Request permissions

              If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.