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Abstract

Objective and Methods

We analyzed the association between serum Troponin I (TnI) ≥ 1.5 ng/ml and clinical variables within a group of congestive heart failure (CHF) patients with low clinical suspicion of acute myocardial infarction (MI). We define low clinical suspicion of MI as no chest pain or ECG ischemic findings and no history of MI. To establish whether the CHF patients with TnI ≥ 1.5 ng/ml had experienced an acute coronary event, we compared them with individuals admitted for a non-Q MI. Results: We included 40 CHF patients with low clinical suspicion of MI (CHF group) and 49 with chest pain (CP) characteristic of an acute coronary event (CP group). Four patients with CHF (CHF high TnI subgroup) and 13 patients with CP (non-Q MI subgroup) had serum TnI values ≥ 1.5 ng/ml. The mean Gensini coronary atherosclerosis score was significantly lower in the former subgroup than in the latter one (0.67 ± 1.15 vs. 28.5 ± 15.28, p = 0.009). The percentage of asynergic regions on left ventriculogram was 0 in CHF high TnI subgroup, significantly lower than in the non-Q MI subgroup (27%). Significant association within the CHF group was found between TnI ≥ 1.5 ng/ml and left ventricular hypertrophy by electrocardiographic criteria (ECG-LVH) (p = 0.004), blood pressure (BP) ≥ 200 systolic or 100 mm Hg diastolic (p = 0.015), pulmonary edema (p = 0.004), and creatinine ≥ 1.5 mg/dl (p = 0.015). Conclusion: In a group of CHF patients with low clinical suspicion of MI, TnI ≥ 1.5 ng/ml did not indicate an MI. Rather, the elevated TnI was associated with ECG-LVH, BP ≥ 200 systolic or 100 mm Hg diastolic, pulmonary edema and creatinine ≥ 1.5 mg/dl.

Heart failure, Troponin I, Left ventricular hypertrophy
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© American Journal of Hypertension, Ltd. 2001
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