139 CARDIAC TROPONIN-T MEASURED BY HIGH SENSITIVITY ASSAY AND ITS ASSOCIATION WITH REVERSIBLE MYOCARDIAL ISCHAEMIA IN PATIENTS WITH AND WITHOUT LV SYSTOLIC DYSFUNCTION. (24th May 2013) - Nadir, M A
Abstract : Introduction: Detectable levels of cardiac troponin-T by high sensitivity assay (hs-TnT) are elevated by both ischaemia and LV systolic dysfunction (LVSD) but it is unknown whether hs-TnT could be a useful biomarker to identify ischaemia either in the presence or the absence of LVSD. Methods: 500 consecutive patients undergoing a clinically indicated dipyridamole myocardial perfusion scintigraphy were studied. Those with impaired renal functions and history of atrial fibrillation or valvular disease were excluded. The troponin-T levels were measured in serum using a highly sensitive assay on an automated platform (Elecsys E170, Roche Diagnostics, lower limit of detection 3 ng/l). All scans were interpreted by a trained physician blinded to the biomarker data. Patients were divided into four groups based on reversible ischaemia and stress ejection fraction (EF) on gated SPECT imaging. Results: Data were available for 453 patients and 97/453 had a reversible ischaemic defect. hsTnT levels were significantly higher in patients with a reversible ischaemia (Median (IQR) 7.2 (3.3–10.9) vs 4.2 (3.0–7.5) pg/ml p<0.001) compared to those without. When analysed according to four groups based on LV function and reversible ischaemia, hsTnT levels were highest in patients with ischaemia and a low EF and lowest in patients with no ischaemia and normal EF (pTREND <0.001) as shown in the table 1 . In a multivariate model which included age, gender, cardiovascular co-morbidities, eGFR, haemoglobin, BNP, and LV ejection fraction, hs-TnT remained an independent predictor of reversible perfusion defect (p=0.026). Conclusions: Baseline hs-cTnT levels are an independent predictor of reversible myocardial ischaemia and this is still the case in the presence of LVSD.Figure 1