Analysis of In-Hospital Evolution of Patients with Unstable Angine According to Troponine T Levels

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Abstract

Background

Temporary occlusion of an epicardial artery under experimental conditions may induce myocardial injury which can be clinically measured by elevated troponinT and CK-MB plasma levels.

Methods

Forty-six patients with previous primary unstable rest angina were studied to determine the efficiency of troponin T enzyme for the detection of high risk patients. To measure serum levels of troponin T, CK and CK-MB venous blood samples were taken before, immediately after, and at 3, 14 and 32hours after admission. Plasma levels higher than 0.1 μg/1 of troponin Tand 16 IU/l of CK-MB were considered positive for myocardial injury. All patients received beta blockers or diltiazem in case of absolute contraindications, aspirin, nitroglycerin and heparin. A two tailed t test was used for statistical analysis. Patients were divided in two groups: group A: 16 with a history of previous cardiac revascularization, and groupB:30 patients without this antecedent.

ResultsIn group A, 13 patients had by-pass surgery and 3 percutaneous transluminal coronary angioplasty. The meantime from the onset of symptoms in this group was28.19 days versus 22.33 days for group B. Troponin T increased in 11.11% of patients (all from group B and none from group A [p= 0.001]).None of the patients had increased levels of CK or CK-MB. Mean time from the onset of symptoms was 7 days for patients with elevated troponin T with a mean absolute value of0.54 μg/l.ConclusionsTroponin T seems to be more sensitive than CK-MB for the detection of myocardial injury in patients with unstable angina. In our study it was observed that patients without previous cardiac revascularization and a shorter time from the onset of symptoms had a significant increase in levels of troponin T.