The Role of Troponin testing in patients with Supraventricular Tachycardia, Systematic Review and Meta-Analysis

Abstract

Background: Supraventricular tachycardia (SVT) is commonly evaluated in the emergency department (ED). While troponin has been shown to be elevated in SVT, its usefulness for predicting coronary artery disease and future adverse cardiovascular outcomes has not been shown. Objectives: We aimed to evaluate the prognostic utility of troponin measurement as part of SVT management in the ED. Methods: We performed a literature search in the PubMed and Scopus databases from inception to August 30, 2023, including all studies reporting troponin measurements in adult patients (age >18 years) presenting to the ED with supraventricular tachycardia. The primary outcome of interest for this study was the prevalence of elevated troponin in patients with SVT. Secondary outcomes included the prevalence of major adverse cardiac events (MACE) and additional cardiac testing with significant findings. Results: We included 7 studies (500 patients) in our analysis. Six studies reported the number of patients with SVT and elevated troponin, with a pooled prevalence of 46% (95% CI 27%-66%, I2 93%). The pooled prevalence of all MACE in our study was 6% (95% CI 1%-25%), while the prevalence for MACE among patients with elevated serum troponin levels was 11% (95% CI 4%-27%). Conclusions: Troponin levels are frequently ordered for ED patients with SVT and are often elevated. However, this review suggests that they have low prognostic value in predicting MACE.