Elevated serum cardiac markers predict coronary artery disease in patients with a history of heart failure who present with chest pain: insights from the i*trACS registry.
The significance of a history of heart failure (HF) in patients presenting with acute coronary syndromes and elevated cardiac markers is unclear. The authors performed an analysis of patients enrolled in the Internet Tracking Registry of Acute Coronary Syndromes (i*trACS). Cardiac marker measurement and cardiac catheterization were performed in 1174 patients. Of these, 116 (9.9%) had heart failure (HF). Coronary artery disease (CAD) was found in 61 (52.6%) patients in the HF group and 581 (54.9%) in the group without HF. In the non-HF cohort, positive markers occurred in 306 patients, in whom 217 (70.9%) had CAD at catheterization. In the HF subset, 24 patients had positive biomarkers and 15 (62.5%) had CAD. A history of HF did not lessen the likelihood of CAD as evidenced by angiography and does not diminish the utility of cardiac markers in diagnosing acute coronary syndromes.
Glauser
Jonathan
J
Division of Medicine, Department of Emergency Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. glausej@ccf.org
Erickson
James
J
Bhatt
Deepak
D
Lindsell
Christopher
C
Gibler
Brian
B
Hoekstra
James
J
Pollack
Charles
C
Hollander
Judd
J
Peacock
W Franklin
WF
D000368:Aged; D000787:Angina Pectoris / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood*; D023921:Coronary Stenosis / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D012107:Research Design; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T; D052279:Creatine Kinase, MB Form