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Myocardial Ischemia on Exercise Stress Echocardiography Testing Is Not Associated with Changes in Troponin T Concentrations

dc.contributor.author Limkakeng, Alexander
dc.contributor.author Drake, Weiying
dc.contributor.author Lokhnygina, Yuliya
dc.contributor.author Meyers, Harvey P
dc.contributor.author Shogilev, Daniel
dc.contributor.author Christenson, Robert H
dc.contributor.author Newby, L Kristin
dc.date.accessioned 2018-08-02T15:29:57Z
dc.date.available 2018-08-02T15:29:57Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/10161/17308
dc.description.abstract Background: Some posit that any amount of myocardial ischemia can be detected by high-sensitivity cardiac troponin assays. We hypothesized that patients with myocardial ischemia induced by exercise stress would have significantly higher increases in high-sensitivity cardiac troponin T (hs-cTnT) concentrations than patients without ischemia.Methods: We prospectively recruited for a biorepository 317 adult patients who presented to an academic hospital emergency department for evaluation possible ischemic symptoms and who were scheduled for exercise echocardiography. Blood samples were obtained before stress testing and 2-h post-testing. For this study, plasma hs-cTnT (Roche Diagnostics) concentrations were determined in a core laboratory blinded to clinical status. Absolute and relative changes between baseline and 2-h post-stress measurements were compared between patients with and without ischemia induced by stress testing.Results: The median age was 51 (44.0, 60.0) years, 45.9% were male, and 37.8% were African American. In total, 26 patients (8.1%) had myocardial ischemia induced by exercise. Median baseline, 2-h post-stress, and absolute δ concentrations were, respectively, 6.0, 8.0, and 0.2 ng/L for patients with evidence of ischemia; 3.8, 4.6, and 0.0 ng/L for those without; and 3.9, 4.9, and 0.0 ng/L overall. Baseline and 2-h hs-cTnT concentrations were higher among patients with abnormal stress tests (all P <=0.05), but absolute and relative changes in hs-cTnT concentrations were not significantly different between individuals with ischemia and individuals without.Conclusions: There was no evidence of change in hs-cTnT values in response to exercise stress testing, regardless of the presence of myocardial ischemia.
dc.publisher The Journal of Applied Laboratory Medicine
dc.relation.ispartof The Journal of Applied Laboratory Medicine
dc.relation.isversionof 10.1373/jalm.2016.021667
dc.title Myocardial Ischemia on Exercise Stress Echocardiography Testing Is Not Associated with Changes in Troponin T Concentrations
dc.type Journal article
dc.date.updated 2018-08-02T15:29:55Z
pubs.begin-page 532
pubs.end-page 543
pubs.organisational-group School of Medicine
pubs.organisational-group Duke
pubs.organisational-group Surgery, Emergency Medicine
pubs.organisational-group Surgery
pubs.organisational-group Clinical Science Departments
pubs.volume 1


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