Can high-sensitive troponin levels within the normal range predict positivity in treadmill test?. Issue 3 (28th May 2023)

• Record Type: Journal Article
• Authors: Yilmaz, Mustafa; Atici, Adem; Sonsöz, Mehmet Rasih; Çevik, Erdem; Orta, Hüseyin; Demirtakan, Zeynep Gizem; Barman, Hasan Ali; Bulat, Zubeyir; Karaayvaz, Ekrem Bilal; Mercanoğlu, Fehmi; Zorkun, Cafer
• Is Part Of: Coronary artery disease. Volume 34:Issue 3(2023)
• Page Start: 202
• Page End: 209
• Publication Date: 2023-05-28
• Subjects: high-sensitivity troponin T -- stable ischemic heart disease -- treadmill test; Coronary heart disease -- Periodicals; Coronary Disease -- Indexes; Coronary Disease -- Periodicals; 616.123005
• DOI: 10.1097/MCA.0000000000001227
• Languages: English
• ISSNs: 0954-6928

Abstract

Abstract : Background: This study aimed to determine whether a high level of high-sensitivity troponin T (hsTnT) predicts a positive treadmill test in patients with suspected stable ischemic heart disease (SIHD). Methods: In all, 366 patients with suspected SIHD were included in the study. We measured the serum hsTnT levels before the treadmill test. The treadmill test was performed according to the Bruce protocol. Results: Of the 366 patients, 97 had positive treadmill tests. The hsTnT levels were significantly higher in the positive group than in the negative group. In the binary logistic regression analysis, hsTnT, pretest probability, metabolic equivalents (METs), target heart rate (THR) percentage, and Duke treadmill score (DTS) were independent predictors of a positive treadmill test [hsTnT odds ratio (OR): 2.178, P < 0.001; pretest probability OR: 1.036, P = 0.007; METs OR: 0.755, P = 0.008; THR OR: 0.773, P < 0.001; DTS OR: 2.661, P = 0.012]. In the receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) value of the model with the combined parameters of hsTnT, pretest probability, METs, THR, and DTS was statistically significant in predicting a positive treadmill test [combined model AUC: 0.945 (0.922–0.968), P < 0.001]. Conclusions: In sum, high pretest hsTnT levels predicted a positive treadmill test in patients with suspected SIHD. Analysis of the hsTnT levels before the treadmill test can increase the sensitivity and specificity of the treadmill test. The methods for measuring hsTnT levels are cheap and easily accessible and can be used before the treadmill test in patients with suspected SIHD.