hs-cTnI Can Rule Out Inducible Myocardial Ischemia in CAD
THURSDAY, Nov. 8, 2018 — For patients with stable coronary artery disease (CAD), very low levels of resting high-sensitivity cardiac troponin I (hs-cTnI) can rule out inducible myocardial ischemia, according to a study published online Nov. 6 in the Annals of Internal Medicine.
Muhammad Hammadah, M.D., from the Emory University School of Medicine in Atlanta, and colleagues conducted an observational study to examine whether low levels of hs-cTnI can identify those without inducible myocardial ischemia among individuals with stable CAD. A total of 589 patients were included in the derivation group and 118 were included in the validation cohort.
The researchers found that in the derivation cohort, 10 of 101 patients with an hs-cTnI level less than 2.5 pg/mL had inducible myocardial ischemia and three of 101 had inducible ischemia involving at least 10 percent of the myocardium. Four of 32 patients in the validation cohort with an hs-cTnI level less than 2.5 pg/mL had inducible ischemia and two had ischemia of 10 percent or greater. No adverse events occurred in patients with an hs-cTnI level less than 2.5 pg/mL after a median follow-up of three years in the derivation cohort, but 7 percent of those with an hs-cTnI level ≥2.5 pg/mL had cardiovascular death or incident myocardial infarction.
“A low plasma level of hs-cTnI identifies patients with CAD who have a very low risk for myocardial ischemia during stress testing and a low medium-term risk for adverse cardiovascular events,” the authors write.
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Posted: November 2018
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