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Can J Cardiol. 2011 Jan-Feb;27(1):105-9. doi: 10.1016/j.cjca.2010.12.004.

Troponin elevation in supraventricular tachycardia: primary dependence on heart rate.

Author information

1
Division of Internal Medicine, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.

Abstract

BACKGROUND:

It is known that some patients with supraventricular tachycardia (SVT) could have increased troponin levels without coronary artery disease.

OBJECTIVES:

To compare the cardiovascular risk of patients admitted with SVT with troponin T elevation (T+ patients) versus those without (T- patients), to determine if the rise in troponin levels could be predicted, and to identify the right approach in T+ patients.

METHODS:

Retrospective database search of patients with SVT from 2002 to 2007 either with or without troponin T elevation at admission.

RESULTS:

Of the 73 study patients, there were 24 (32.9%) T+ patients and 49 (67.1%) T- patients. All except 5 T+ patients underwent either a stress test/MIBI or a coronary angiogram. Two noninvasive tests were positive and only 1 patient needed an angiogram and percutaneous coronary intervention; none of the other angiograms triggered any further treatment. Of the 49 T- patients, 11 had a noninvasive stress test; none of these tests was positive or triggered any further treatment. Compared with that of T- patients, the maximum heart rate was significantly higher in T+ patients (190.8 versus 170.3 beats per minute, P = .008). A correlation was found between the maximal heart rate during SVT and the level of troponin elevation (r = 0.637, P = .001).

CONCLUSIONS:

SVT could be associated with a troponin elevation without any severe coronary artery disease. In most patients, either conservative management or noninvasive stratification seems to be sufficient; an invasive strategy could then be reserved only for high-risk patients who tested positive. The only clinical variable correlated with the troponin rise was a higher maximal heart rate during the SVT episode.

PMID:
21329868
DOI:
10.1016/j.cjca.2010.12.004
[Indexed for MEDLINE]

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