Dynamic high-sensitivity troponin elevations in atrial fibrillation patients might not be associated with significant coronary artery disease
Thelin, Johan LU and Melander, Olle LU
(2017)
In BMC Cardiovascular Disorders
17(1).
- Abstract
Background: Since the introduction of high-sensitivity troponin assays a greater proportion of atrial fibrillation (AF) patients present with dynamic troponin elevations. We hypothesize that significant coronary artery disease (CAD) causes relative ischemia in the setting of a rapid heart rate resulting in dynamic troponin elevation. The aim of this study was to examine if patients without known CAD who present with AF, tachycardia and dynamic high-sensitivity troponin T (hsTnT) change have an increased risk of cardiac events. Methods: We retrospectively included AF patients presenting with tachycardia during one year. The primary endpoint was acute coronary syndrome, revascularization or death due to ischemic heart disease during 30... (More)
Background: Since the introduction of high-sensitivity troponin assays a greater proportion of atrial fibrillation (AF) patients present with dynamic troponin elevations. We hypothesize that significant coronary artery disease (CAD) causes relative ischemia in the setting of a rapid heart rate resulting in dynamic troponin elevation. The aim of this study was to examine if patients without known CAD who present with AF, tachycardia and dynamic high-sensitivity troponin T (hsTnT) change have an increased risk of cardiac events. Methods: We retrospectively included AF patients presenting with tachycardia during one year. The primary endpoint was acute coronary syndrome, revascularization or death due to ischemic heart disease during 30 months follow-up. Results: Five hundred twenty-two patients without known CAD were included, 300 (57%) had normal hsTnT and 49 (9.5%) had dynamic hsTnT elevation. During follow-up 12 (4%) patients with normal hsTnT reached the primary endpoint and a total of 14 (4.7%) patients died. In the group with dynamic hsTnT the results were 4 (8.2%) and 12 (25%) respectively. The age-adjusted hazard ratio (HR) for the primary endpoint in patients with dynamic hsTnT was 1.9 (95% CI: 0.6 to 6.2; p = 0.28) and for all-cause mortality 3.8 (95% CI: 1.7 to 8.5; p = 0.001). Conclusions: Dynamic hsTnT elevation in connection with AF might not be associated with any major increased risk of coronary events, but indicates increased all-cause mortality.
(Less)
- author
- Thelin, Johan
LU
and Melander, Olle
LU
- organization
- publishing date
- 2017-06-27
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Atrial fibrillation, Coronary artery disease, High sensitivity troponin, Tachycardia, Type 2 myocardial infarction
- in
- BMC Cardiovascular Disorders
- volume
- 17
- issue
- 1
- article number
- 169
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:28655300
- wos:000404167000001
- scopus:85021268476
- ISSN
- 1471-2261
- DOI
- 10.1186/s12872-017-0601-7
- language
- English
- LU publication?
- yes
- id
- bebee546-410f-42f3-854b-e0607aa2af86
- date added to LUP
- 2017-08-10 11:43:23
- date last changed
- 2025-01-07 18:26:13
@article{bebee546-410f-42f3-854b-e0607aa2af86,
abstract = {{<p>Background: Since the introduction of high-sensitivity troponin assays a greater proportion of atrial fibrillation (AF) patients present with dynamic troponin elevations. We hypothesize that significant coronary artery disease (CAD) causes relative ischemia in the setting of a rapid heart rate resulting in dynamic troponin elevation. The aim of this study was to examine if patients without known CAD who present with AF, tachycardia and dynamic high-sensitivity troponin T (hsTnT) change have an increased risk of cardiac events. Methods: We retrospectively included AF patients presenting with tachycardia during one year. The primary endpoint was acute coronary syndrome, revascularization or death due to ischemic heart disease during 30 months follow-up. Results: Five hundred twenty-two patients without known CAD were included, 300 (57%) had normal hsTnT and 49 (9.5%) had dynamic hsTnT elevation. During follow-up 12 (4%) patients with normal hsTnT reached the primary endpoint and a total of 14 (4.7%) patients died. In the group with dynamic hsTnT the results were 4 (8.2%) and 12 (25%) respectively. The age-adjusted hazard ratio (HR) for the primary endpoint in patients with dynamic hsTnT was 1.9 (95% CI: 0.6 to 6.2; p = 0.28) and for all-cause mortality 3.8 (95% CI: 1.7 to 8.5; p = 0.001). Conclusions: Dynamic hsTnT elevation in connection with AF might not be associated with any major increased risk of coronary events, but indicates increased all-cause mortality.</p>}},
author = {{Thelin, Johan and Melander, Olle}},
issn = {{1471-2261}},
keywords = {{Atrial fibrillation; Coronary artery disease; High sensitivity troponin; Tachycardia; Type 2 myocardial infarction}},
language = {{eng}},
month = {{06}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Cardiovascular Disorders}},
title = {{Dynamic high-sensitivity troponin elevations in atrial fibrillation patients might not be associated with significant coronary artery disease}},
url = {{http://dx.doi.org/10.1186/s12872-017-0601-7}},
doi = {{10.1186/s12872-017-0601-7}},
volume = {{17}},
year = {{2017}},
}