Relationship between high-sensitive troponin T levels in patients with acute coronary syndrome with ST elevation and complex coronary lesions

Abstract

High-sensitive troponin T (hsTnT) has been associated with diagnosis and prognostic of acute coronary syndromes, and it was associate in some studies with the extension and severe coronary lesions in the acute coronary syndromes without ST elevation, but it is not well established the relationship with the extension and severe coronary lesions in patients with an acute coronary syndromewith ST elevation (STEMI) [1-5]. We sought to explore the relation between hsTnT levels and extension of coronary artery disease (CAD) and the presence of more complex and severe coronary lesions in patients with STEMI. This is an observational study, which included 53 patients admitted with STEMI. High-sensitive troponin T was performed at a median time of 3 hours after admission and analyzed. We consider a positive hsTnT when was more than 14 ng/L. Angiogramswere read, and complex coronary lesionwas defined as the presence of at least one of the following: coronary lesion more than 90%, coronary lesion more than 50% in the left main coronary artery, 2 or more vessels affected with lesion more than 70%, the presence of thrombus, TIMI flow less than 2, or ulcerated plaque. The levels of hsTnT were directly related to the extent of the CAD. Patients with complex coronary lesions had higher levels of hsTnT compared with those without complex coronary lesions. After adjusting for clinical and electrocardiographic variables and positive hsTnT (odds ratio, 3.20; 95% confidence interval, 2.50-4.11; P b .0001) and median hsTnT levels (odds ratio, 2.12; 95% confidence interval, 2.01-2.74; P b .01) independently contributed to the prediction of complex coronary lesions. We conclude that patients with STEMI hsTnT levels progressively increase with the severity of CAD. Increased levels of hsTnT independently predict the presence of more complex coronary lesions. This study showed similar results than patients with acute coronary syndromes without ST elevation.