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Predictors of Stress-Delta High-Sensitivity Troponin T in Emergency Department Patients Undergoing Stress Testing.

Publication ,  Journal Article
White, EJ; Susman, SJ; Bouffler, A; Leahy, JC; Griffin, SM; Christenson, R; Newby, LK; Gordee, A; Kuchibhatla, M; Limkakeng, AT
Published in: Cureus
September 2022

Background and objective Elevations in high-sensitivity troponin T (hs-TnT) are frequently observed following extreme physical exercise. In light of this, we sought to determine whether specific clinical characteristics are associated with this phenomenon in patients undergoing cardiac exercise tolerance testing (ETT). Methods We conducted a retrospective analysis of a prospectively collected biospecimen repository of 257 patients undergoing a stress echocardiogram for possible acute coronary syndrome (ACS). Ischemic electrocardiogram (ECG) changes during ETT and the presence or absence of ischemia on imaging were determined by a board-licensed cardiologist. N-terminal pro-brain natriuretic peptide (NT-proBNP) and hs-TnT assays were obtained immediately before and two hours following ETT. We developed linear regression models including several clinical characteristics to predict two-hour stress-delta hs-TnT. Variable selection was performed using the least absolute shrinkage and selection operator (LASSO). Results The mean age of the patients was 52 years [standard deviation (SD): 11.4]; 125 (48.6%) of them were men, and 88 (34.2%) were African-American. Twenty-two patients (8.6%) had ischemia evident on echocardiography, and 31 (12.1%) had ischemic ECG changes during exercise. The mean baseline hs-TnT was 5.6 ng/L (SD: 6.4) and the mean two-hour hs-TnT was 7.1 ng/L (SD: 10.2). Age and ischemic ECG changes were associated with two-hour stress-delta hs-TnT values. Conclusions Based on our findings, ischemic changes in stress ECG and age were associated with an increase in hs-TnT levels following exercise during a stress echo.

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Published In

Cureus

DOI

ISSN

2168-8184

Publication Date

September 2022

Volume

14

Issue

9

Start / End Page

e29601

Location

United States

Related Subject Headings

  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences
 

Citation

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Chicago
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White, E. J., Susman, S. J., Bouffler, A., Leahy, J. C., Griffin, S. M., Christenson, R., … Limkakeng, A. T. (2022). Predictors of Stress-Delta High-Sensitivity Troponin T in Emergency Department Patients Undergoing Stress Testing. Cureus, 14(9), e29601. https://doi.org/10.7759/cureus.29601
White, Emily J., Stephen J. Susman, Andrew Bouffler, J Clancy Leahy, S Michelle Griffin, Robert Christenson, L Kristin Newby, Alexander Gordee, Maragatha Kuchibhatla, and Alexander T. Limkakeng. “Predictors of Stress-Delta High-Sensitivity Troponin T in Emergency Department Patients Undergoing Stress Testing.Cureus 14, no. 9 (September 2022): e29601. https://doi.org/10.7759/cureus.29601.
White EJ, Susman SJ, Bouffler A, Leahy JC, Griffin SM, Christenson R, et al. Predictors of Stress-Delta High-Sensitivity Troponin T in Emergency Department Patients Undergoing Stress Testing. Cureus. 2022 Sep;14(9):e29601.
White, Emily J., et al. “Predictors of Stress-Delta High-Sensitivity Troponin T in Emergency Department Patients Undergoing Stress Testing.Cureus, vol. 14, no. 9, Sept. 2022, p. e29601. Pubmed, doi:10.7759/cureus.29601.
White EJ, Susman SJ, Bouffler A, Leahy JC, Griffin SM, Christenson R, Newby LK, Gordee A, Kuchibhatla M, Limkakeng AT. Predictors of Stress-Delta High-Sensitivity Troponin T in Emergency Department Patients Undergoing Stress Testing. Cureus. 2022 Sep;14(9):e29601.

Published In

Cureus

DOI

ISSN

2168-8184

Publication Date

September 2022

Volume

14

Issue

9

Start / End Page

e29601

Location

United States

Related Subject Headings

  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences