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). CONCLUSION: 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.
Elevated admission cardiac troponin T is associated with microvascular dysfunction in acute myocardial infarction treated with emergency angioplasty / Porto, I; Burzotta, F; Brancati, M; Trani, C; Lombardo, A; Romagnoli, E; Niccoli, G; Leone, Am; Natale, L; Biasucci, Lm; Crea, F. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2027. - 10(2009), pp. 664-668. [10.2459/JCM.0b013e3283252b32]
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