title: Elevated admission cardiac troponin T is associated with microvascular dysfunction in acute myocardial infarction treated with emergency angioplasty.
abstract: BACKGROUND
  We speculated that elevated admission cardiac troponin T (cTnT) could predict worse microvascular function in patients with ST-elevation myocardial infarction who are managed with emergency percutaneous coronary intervention.
  
  
  METHODS
  In 27 patients with ST-elevation myocardial infarction, we obtained admission cTnT, angiography at the time of intervention, and cardiovascular magnetic resonance after 3 days.
  
  
  RESULTS
  Elevated admission cTnT was associated with a higher corrected Thrombolysis In Myocardial Infarction frame count (P = 0.04) and with a trend toward worse myocardial blush grade at the end of the procedure (P = 0.069), indicating a higher degree of microvascular obstruction. This was confirmed by its correlation with the size of perfusion defect seen at first-pass cardiovascular magnetic resonance (rho = 0.42, P = 0.028). In contrast, admission cTnT did not correlate with the amount of muscle necrosis as seen by delayed-enhancement cardiovascular magnetic resonance (rho = 0.12, P = 0.55).
  
  
  CONCLUSIONS
  Elevated admission cTnT predicts worse microvascular function in ST-elevation myocardial infarction patients managed with emergency percutaneous coronary intervention. Measuring admission cTnT might provide the interventionalist with useful information for selecting additional therapies that benefit coronary microcirculation.
authors.affiliation: Department of Cardiovascular Medicine, Italy. i.porto@doctors.org.uk
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Marta
authors.initials: M
authors.lastname: Brancati
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Antonella
authors.initials: A
authors.lastname: Lombardo
authors.forename: Enrico
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.forename: Luigi
authors.initials: L
authors.lastname: Natale
authors.forename: Luigi Marzio
authors.initials: LM
authors.lastname: Biasucci
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology* / Q000628:therapy; D010343:Patient Admission; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T