Mild troponin I elevation does not predict ischemia on myocardial perfusion imaging
Introduction. Data are limited on the degree of mild troponin I elevation and clinical risk factors in predicting myocardial ischemia. Methods. Hospitalized adult patients who underwent myocardial perfusion imaging (MPI) from 2015 to 2016 at Rochester General Hospital and had mild troponin I elevation (>0.1 and <1.5 ng/mL) were included. Predictors of outcomes were determined using logistic regression model. Results. One hundred and sixty-six patients with mild troponin I elevation who underwent MPI were followed. Mean age was 69.6 ± 12.5 years and 53.0% of the patients were female. Fourteen patients (8.4%) presented with typical chest pain (CP), 60 patients (36.1%) had atypical CP and 92 patients (55.4%) had no CP on presentation. MPI was positive for ischemia in 45 patients (27.1%). There was no difference in peak troponin I level with ischemia versus no ischemia on MPI (0.34 ng/dL [0.13-0.69] vs. 0.23 ng/dL [0.14-0.50], p value 0.254). Atypical CP did not predict the presence of ischemia on MPI (odds ratio [OR] 1.97, 95% confidence interval [CI] 0.91-4.26). Coronary artery disease (CAD) history (age and sex adjusted p value 0.013), diabetes (adjusted p value 0.036), creatinine ≥2 mg/dL (adjusted p value 0.019) and dialysis (adjusted p value 0.006) were statistically significant predictors of ischemia on MPI. Conclusions. In patients presenting with mild troponin I elevation, peak troponin I level did not predict ischemia on MPI. The presence of CAD history, diabetes, elevated creatinine and dialysis were predictors of ischemia on MPI.
Myocardial perfusion imaging, Risk factors, Troponin I
Financial support: No grants or funding have been received for this study.
Le Dung Ha Rochester General Hospital 1425 Portland Avenue Rochester, 14621 NY, USA firstname.lastname@example.org
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