Abstract
ObjectiveTo study the relevance of high-sensitive troponin measurements in the acute workup in patients admitted to the emergency department of a large university hospital due to syncope.MethodsIn this retrospective study all patients admitted to the emergency department because of syncope of the Inselspital, University Hospital Bern between 01 August 2010 and 31 October 2012, with serial determination of high-sensitive troponin (baseline and three hours control) were included. Of all identified patients we obtained data on demographics, laboratory data, ECG as well as on outcome. A change in high-sensitive troponin in the three hours control of +/−30% compared to baseline was considered significant.ResultsA total of 121 patients with a mean age of 67 years (SD 16) were included in the study. 79 patients (65%) were male and 42 (35%) were female. There was no significant difference in the median high sensitive-troponin level at baseline and in the three hours control (0.01 mcg/L [0.003 to 0.022] versus 0.011 mcg/L [0.003 to 0.022], p = 0.47). Median percent change in high-sensitive troponin level between baseline and control was 0% (−9.1 to 5). 51 patients (42%) had elevated high-sensitive troponin levels at baseline with 7 patients (6%) showing a dynamic of +/−30% change from the baseline measurement in the 3 hours control. 3 of these patients received coronary angiography due to the dynamic in high-sensitive troponin, none of whom needed intervention for coronary revascularization.ConclusionsOn basis of the current study, where no single patient took benefit from determination of high-sensitive troponin, measurement of cardiac troponins should be reserved for patients with syncope presenting with symptoms suggestive for the presence of an acute cardiac syndrome.
Highlights
In the Guidelines of the European Society of Cardiology, syncope is defined as a transient loss of consciousness caused by a self-limiting global cerebral hypoperfusion characterized by rapid onset, short duration, and spontaneous complete recovery [1]
Neither the guidelines of the American Heart Association nor those of the European Society of Cardiology recommend tests for highsensitive troponin in patients presenting with syncope, cardiac troponins are often determined in these patients in daily clinical practice, despite syncope is not regarded a classic symptom of acute coronary syndrome
We hypothesized that serial determination of high-sensitive troponin to detect unstable coronary artery disease as an underlying cause of syncope does not result in a benefit in the workup of patients presenting to an emergency department (ED) due to syncope
Summary
In the Guidelines of the European Society of Cardiology, syncope is defined as a transient loss of consciousness caused by a self-limiting global cerebral hypoperfusion characterized by rapid onset, short duration, and spontaneous complete recovery [1]. Neither the guidelines of the American Heart Association nor those of the European Society of Cardiology recommend tests for highsensitive troponin in patients presenting with syncope, cardiac troponins are often determined in these patients in daily clinical practice, despite syncope is not regarded a classic symptom of acute coronary syndrome. We hypothesized that serial determination of high-sensitive troponin to detect unstable coronary artery disease as an underlying cause of syncope does not result in a benefit in the workup of patients presenting to an ED due to syncope
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
