Vol. 9, No 3, 2002 pp. 240 - 244
UC 616.12-029.72
TROPONIN T IN UNSTABLE ANGINA PECTORIS
Ivana M. Burazor, Mirko Burazor
Clinic for Cardiovascular Diseases, Clinical Center Niš, Serbia and
Montenegro
E-mail: burazori@eunet.yu
Summary. Unstable angina pectoris is nowadays defined as an acute
coronary syndrome commonly marked by a non-specific electrocardiogram changes.
For this reason, unstable angina is associated with problems in its differentiation
and diagnosis. Due to the development of biochemical methods, it has become
possible to determine the levels of highly specific cardiac troponin T
(TnT) in a short period of time and thereby to take the right direction
in approaching the patient with acute coronary syndrome (ACS) and short-term
prognosis.
The aim of the study was to determine TnT values in patients on admission
to Coronary Unit of the Clinic for Cardiovascular Diseases of the Clinical
Center-Niš, to identify new events during the follow-up, and to assess
the possibilities of this marker application in short-term prognosis.
A total of 30 patients were treated, with an average age of 61ą10.85
years, of whome 18 were males and 12 females. Anamnestic data were taken
that relate to pain and risk factors, and a detailed laboratoty analysis
was done that also included determination of values of cardiac specific
enzymes. Troponin T was determined quantitatively on the Cardiac Reader
analyzer on the site of blood sample, in the Coronary Unit. All treated
patients were monitored during their hospitalization and all through control
examination after six week's time for possible new events.
Troponin T was detected in 12 (40%) patients with unstable pectoral
angina at 0.18+0.07 ng/ml value. Of these patients, six developed a new
event during the follow-up for acute myocardial infarction (AMI). Exitus
was not registered. On control examination, seven patient were identified
to have undergone coronarograpgy and to have TnT value of 0.17+0.05 ng/ml.
In four patients, no change on electrocardiogram was observed.
The study allowed for distinguishing the group termed as troponin T
positive angina. These patients have not only a worse prognosis but are
also in need of cardiosurgical intervention suggestive of their coronography
finding.
Key words: Unstable angina pectoris, troponin T, coronography,
minor myocardial damage
TROPONIN T U NESTABILNOJ ANGINI PEKTORIS
Kratak sadržaj: Nestabilna angina pektoris u današnje vreme se definiše
kao akutni koronarni sindrom često praćen ne karakterističnim elektrokardiogramskim
promenama zbog čega predstavlja diferencijalno - dijagnostički problem.
Zahvaljujući razvoju biohemijskih metoda danas je u kratkom vremenskom
intervalu moguće odrediti nivoe visoko specifičnog kardio troponina T i
time se brzo orijentisati u prilazu pacijentu sa akutnim koronarnim sindromom
(AKS) i kratkoročnoj prognozi.
Cilj studije bio je odrediti vrednosti troponina T (Tn T) u trenutku prijema
u Koronarnu jedinicu Klinike za kardiologiju u Nišu, nove događaje u periodu
praćenja kao i mogućnost primene ovog markera u kratkoročnoj prognozi.
Ispitano je 30 bolesnika prosečne starosti 61 + 10.85 godina i to 18 muškaraca
i 12 žena. Notirani su anamnestički podaci o bolu i faktorima rizika, detaljno
urađen laboratorijski pregled koji je obuhvatio i proveru vrednosti kardiospecifičnih
enzima. Troponin T određivan je kvantitativno na aparatu Cardiac Reader
na mestu uzimanja krvi, u Koronarnoj jedinici. Ispitanici su praćeni kako
tokom hospitalizacije tako i do kontrolnog pregleda urađenog nakon 6 nedelja
u smislu pojave novog događaja.
Troponin T bio je detektibilan u 12 (40%) bolesnika sa nestabilnom anginom
pektoris i to u vrednostima od 0.18 + 0.07 ng/ml. Od njih 6 je razvilo
novi događaj u periodu praćenja u smislu infarkta miokarda (AMI), nije
bilo egzitusa. Na kontrolnom pregledu utvrđeno je da je 7 bolesnika bilo
podvrgnuto koronarografiji i da su oni imali vrednosti Tn T 0.17
+ 0.05 ng/ml dok elektrokardiogram nije pokazivao karakteristične promene
u 4 bolesnika.
Sprovedeno ispitivanje izdvaja grupu označenu kao Troponin T pozitivna
angina. Ovi bolesnici imaju ne samo lošiju prognozu nego i potrebu za kardiohirurškom
intervencijom shodno koronarografskom nalazu.
Ključne reči: Troponin T, nestabilna angina pektoris, koronarografija,
minorno oštećenje miokarda
