Original scientific paper

https://doi.org/10.15836/ccar2019.159

Causes of Elevated Troponin in Patients with Normal Coronary Angiography

Ana Reschner Planinc ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Maja Strozzi ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Zoran Miovski ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Kristina Marić Bešić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Joško Bulum ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Abstract

Troponin elevation usually indicates myocardial cell injury. However, elevated values of
troponin are not always a consequence of infarction or ischemia. The aim of this study was to elucidate
the diverse etiologies of elevated troponin in patients with normal coronary angiography. There were
947 patients at the Zagreb University Hospital Centre identified from the catheterization database who
underwent coronary angiography in 2014 due to suspected acute coronary syndrome. We identified 32
(3.38%) patients who had an alternative cause for myocyte injury other than coronary artery disease,
defined as coronary artery lumen stenosis above 30%. The elevation of cardiac troponin T (cTnT) in
patients with normal coronary angiography was found to be the consequence of diverse etiologies, including
hypertensive heart disease, Takotsubo syndrome, supraventricular tachycardia, myocarditis,
and dilated cardiomyopathy, to name a few. Apart from acute coronary syndrome, cTnT can be elevated
in a number of different conditions, which should be considered according to clinical presentation, and
that could still reflect myocardial necrosis even in the absence of significant coronary artery disease.

Keywords

cardiac troponin; coronary artery disease; normal coronary angiography; myocardial cell injury

Hrčak ID:

226608

URI

https://hrcak.srce.hr/226608

Publication date:

17.9.2019.

Article data in other languages: croatian

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