Increase of serum troponin I and ST-segment depression are objective markers of myocardial
ischemia/injury. Abnormalities of the 2 indicators have been associated with supraventricular
tachycardia (SVT) but their relevance for diagnosing acute coronary syndrome and the
presence of coronary artery disease (CAD) in this setting have not been clarified.
Therefore, we sought to evaluate the frequency of CAD based on increased troponin
I and ST-segment depression during SVT. During a 5-year period, 104 patients were
admitted with a diagnosis of SVT, 80 of whom had troponin I testing, and 70 of these
patients could be assessed for ST-segment changes. Thirty-seven patients (48%) had
increased troponin I (mean 1.54 ± 2.7 ng/dl, normal ≤0.07 ng/dl) and 46 patients (57%)
had ST-segment depression ≥1.0 mm. There were no significant differences in baseline
characteristics and clinical presentation of patients with and without troponin I
increase or ST-segment depression. There was no difference in the diagnosis of CAD
by noninvasive or invasive testing in patients with and without increased troponin
I. More patients with than without ST-segment depression had evidence of CAD (22%
vs none, p = 0.01), but after adjusting for covariates, ST-segment depression was
not a significant predictor of CAD. In conclusion, increased troponin I and ST-segment
depression are not significant markers of acute coronary syndrome in patients with
SVT.
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Article info
Publication history
Accepted:
March 9,
2010
Received in revised form:
March 9,
2010
Received:
January 21,
2010
Footnotes
Dr. Srivatsa was supported by National Institutes of Health Grant K30 at the time of the project.
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
