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INVESTIGATION OF HIGH-SENSITIVITY TROPONIN I LEVELS AND THEIR CORRELATION WITH CLINICAL AND PARACLINICAL FACTORS IN PATIENTS WITH ARRHYTHMIAS
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Background: Elevated high-sensitivity cardiac troponin I (hs-cTnI) is frequently observed in patients with cardiac arrhythmias, complicating the diagnosis of underlying coronary artery disease (CAD). This study investigated the characteristics of hs-cTnI, its correlation with clinical factors, and its diagnostic utility for CAD in arrhythmia patients. Methods: A cross-sectional study was conducted on 244 patients admitted with arrhythmias (atrial fibrillation, ventricular tachycardia, and bradyarrhythmias) at a tertiary referral center. We analyzed correlations between hs-cTnI and hemodynamic/biochemical markers. Receiver Operating Characteristic (ROC) analysis was performed to determine the optimal cut-off value for predicting CAD. Results: Elevated hs-cTnI (>99th percentile) was present in 42.2% of the cohort, with the highest prevalence in the atrial fibrillation group. hs-cTnI exhibited a strong positive correlation with NT-proBNP (r = 0.612, p < 0.001) but no significant correlation with heart rate. Multivariate regression identified NT-proBNP and the presence of CAD as independent predictors of elevated hs-cTnI. Patients with CAD had significantly higher median hs-cTnI levels compared to those without (116.6 vs. 9.3 pg/mL, p < 0.001). An optimal cut-off of ≥ 36 pg/mL yielded an Area Under the Curve (AUC) of 0.84, offering 82% sensitivity and 76% specificity for CAD prediction. Conclusion: In arrhythmia patients, hs-cTnI elevation reflects both hemodynamic stress and potential ischemia. An optimized cut-off of 36 pg/mL improves diagnostic accuracy for CAD compared to the standard reference limit, helping to reduce false-positive rates.
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Từ khóa
High-sensitivity Troponin I, Arrhythmia, Coronary Artery Disease, NT-proBNP, Diagnostic value.
Tài liệu tham khảo
2. Clerico A, Zaninotto M, Aimo A, Padoan A, Passino C, Fortunato A, et al. Advancements and challenges in high-sensitivity cardiac troponin assays: diagnostic, pathophysiological, and clinical perspectives. Clin Chem Lab Med. 2025;63(7):1260-78.
3. Costabel JP, Urdapilleta M, Lambardi F, Campos R, Vergara JM, Ariznavarreta P, et al. High-Sensitivity Cardiac Troponin Levels in Supraventricular Tachyarrhythmias. Pacing Clin Electrophysiol. 2016;39(6):588-91.
4. Fernando H, Adams N, Mitra B. Investigations for the assessment of adult patients presenting to the emergency department with supraventricular tachycardia. World J Emerg Med. 2020;11(1):54-9.
5. Gabrielli M, Cucurachi R, Lamendola P, Candelli M, Pignataro G, Del Bono G, et al. Troponin Testing in Adult Patients Presenting to the Emergency Department for Paroxysmal Supraventricular Tachycardia: A Review. Cardiol Rev. 2023;31(5):265-9.
6. Li Z, Tao J, Wang H, Zhang Q, Liu Q, Wang Q, et al. High-Sensitivity cardiac troponin I in the diagnosis of acute myocardial infarction: A study in patients with renal insufficiency. Am Heart J Plus. 2025;59:100631.
7. Maayah M, Grubman S, Allen S, Ye Z, Park DY, Vemmou E, et al. Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing. Diagnostics (Basel). 2024;14(5).
8. Thomsen T, Funken M, Nickenig G, Becher MU. High Sensitivity Cardiac Troponin T Versus Cardiac Troponin I on Prediction of Significant Coronary Artery Disease in Patients Hospitalized Due to Symptomatic Atrial Fibrillation. J Clin Med. 2025;14(6).