Elevated admission cardiac troponin T is associated with microvascular dysfunction in acute myocardial infarction treated with emergency angioplasty.
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.
Porto
Italo
I
Department of Cardiovascular Medicine, Italy. i.porto@doctors.org.uk
Burzotta
Francesco
F
Brancati
Marta
M
Trani
Carlo
C
Lombardo
Antonella
A
Romagnoli
Enrico
E
Niccoli
Giampaolo
G
Leone
Antonio Maria
AM
Natale
Luigi
L
Biasucci
Luigi Marzio
LM
Crea
Filippo
F
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*
D020107:Troponin T