Abstract 42: Cardiac Troponin and Extent of Coronary Artery Disease After Resuscitated Sudden Cardiac Arrest

Abstract

Interpretation of cardiac troponin after resuscitated sudden cardiac arrest is often difficult because increased values may be caused by cardiac arrest, resuscitation procedures and concomitant myocardial infarction due to obstructive coronary disease. In the present study, we related peak cardiac troponin I (TnI), early postresuscitation electrocardiogram (ECG) and coronary anatomy obtained by urgent coronary angiography following reestablishment of spontaneous circulation (ROSC). Postresuscitation electrocardiogram (ECG) revealed STEMI in 183 patients of whom 179 had at least one obstructive lesion. In 66 patients with ECG patterns other than STEMI, 44 had obstructive coronary disease. As shown in table, peak troponin was much greater in STEMI than in no STEMI groups. Within no STEMI group, greater peak TnI was associated with presence of obstructive coronary artery disease. In conclusion, while great majority of patients with STEMI after ROSC have evidence of at least one obstructive lesion, increased levels of troponin in patients without STEMI indicate presence of at least one obstructive lesion and may thereby facilitate decision for coronary angiography if not performed already on admission.