Rafael Y Brzezinski1, Eyal Fisher2, Michal Ehrenwald1, Gabi Shefer3, Naftali Stern3, Itzhak Shapira1, David Zeltser1, Shlomo Berliner1, Shani Shenhar-Tsarfaty1, Assi Milwidsky4, Ori Rogowski1. 1. Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. Department of Statistics, School of Mathematical Science, Tel Aviv University, Tel Aviv, Israel. 3. Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel. 4. Department of Cardiology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: The exercise ECG stress test (EST) is still the first step of work-up in intermediate risk patients in many clinical scenarios. High-sensitive cardiac troponin T (hs-cTnT) elevation is related to future cardiovascular events in the general population and in patients with ischaemic heart disease. The relation between these 2 tests is not well described. MATERIALS AND METHODS: A total of 2780 participants from the Tel-Aviv Medical Center Inflammation Survey cohort (mean age 49 years, 79% men) were analysed. Multiple physiologic and metabolic parameters including hs-cTnT were collected. All participants completed an EST manually reviewed by a cardiologist. RESULTS: A positive EST was documented in 224 subjects (8%). The majority (91%) of participants with hs-cTnT levels of 5-14 ng/L had a negative EST as well as 89.3% of subjects with levels >14 ng/L. The proportion of subjects with a positive EST and detectable hs-cTnT levels (>5 ng/L) was not significantly greater compared to those with a negative EST (53.1% vs 46.2%, respectively, P = .09). CONCLUSION: Among subjects referred for EST as part of an annual health survey, we found no significant association between EST results to hs-cTnT detection.
BACKGROUND: The exercise ECG stress test (EST) is still the first step of work-up in intermediate risk patients in many clinical scenarios. High-sensitive cardiac troponin T (hs-cTnT) elevation is related to future cardiovascular events in the general population and in patients with ischaemic heart disease. The relation between these 2 tests is not well described. MATERIALS AND METHODS: A total of 2780 participants from the Tel-Aviv Medical Center Inflammation Survey cohort (mean age 49 years, 79% men) were analysed. Multiple physiologic and metabolic parameters including hs-cTnT were collected. All participants completed an EST manually reviewed by a cardiologist. RESULTS: A positive EST was documented in 224 subjects (8%). The majority (91%) of participants with hs-cTnT levels of 5-14 ng/L had a negative EST as well as 89.3% of subjects with levels >14 ng/L. The proportion of subjects with a positive EST and detectable hs-cTnT levels (>5 ng/L) was not significantly greater compared to those with a negative EST (53.1% vs 46.2%, respectively, P = .09). CONCLUSION: Among subjects referred for EST as part of an annual health survey, we found no significant association between EST results to hs-cTnT detection.
Authors: Udi Shapira; Mor Krubiner; Michal Ehrenwald; Itzhak Shapira; David Zeltser; Shlomo Berliner; Ori Rogowski; Shani Shenhar-Tsarfaty; Amir Bar-Shai Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-03-07