TROPONIN-I POSITIVITY IN PATIENTS REFERRED TO RAPID ACCESS CHEST PAIN CLINIC
Abstract
Background: Rapid Access Chest Pain Clinics (RACPCs) are set up to access patients with new onsetchest pain (within the preceding three weeks), of possible cardiac origin. These patients are seen in theclinic within two weeks of referral and the attending physician takes a history, performs a routineclinical examination, and if clinically justified, a treadmill exercise test is performed according to BruceProtocol. Within the group of patients referred to the RACPC with new onset but otherwise stableangina, there is a potential overlap with patients who in fact may have an evolving acute coronarysyndrome, i.e., unstable angina. The aim of this study was to assess the prevalence of Troponin-Ipositivity as an indicator of acute coronary syndrome. Methods: This cross-sectional descriptive studyincluded 60 consecutive patients referred to the RACPC with history of recent onset chest pain (withinthe last three weeks) of possible cardiac origin and positive ETT or confirmed abnormal ischemic ECGat baseline. Troponin-I was measured in these patients. Results: Out of the total 60 patients, 8.33% ofthe patients referred to RACPC with new onset angina had positive cTnI. Conclusion: Point of care test(POCT) for cTnI can help to identify the high risk patient referred to RACPC.Keywords: Troponin-I, cTnI, Troponin-T, Rapid Access Chest Pain Clinic, Angina, Unstableangina, Myocardial infarction, Non-ST elevation MI, Acute coronary syndromeReferences
Braunwald E. Unstable angina: a classification. Circulation
;80:410–14.
Chaitman BR. Exercise stress testing. In: Heart Disease.
Braunwald E, ed. Philadelphia: WB Saunders Company;
p.153–76.
Stuart RJ, Ellestad MH. National survey of exercise testing
facilities. Chest 1980;77:94–7.
Gordon NF, Kohl HW. Exercise testing and sudden death. J
Cardiopulm Rehabil 1993;13:381–6.
Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P,
Colombo A, et al. Exercise-induced ST depression in the
diagnosis of coronary artery disease, a meta-analysis.
Circulation 1989;80:87–98.
Eryol N.M, Basar E, Oguzhan A, Ciçek Y, Abaci A,
Oguzhan A, et al. Should Troponin-T be assessed during
exercise stress testing in patient with angina pectoris.
Anadolu Kardiyol Derg 2002;2(2):132–7.
Akdemir I, Aksoy N, Aksoy M, Davutoglu V, Dinckal H.
Does exercise-induced severe ischaemia result in elevation of
plasma troponin-T level in patients with chronic coronary
artery disease? Acta Cardiol 2002;57(1):13–8.
Antman EM, Tanasijevic MJ, Braunwald E, Schactman M,
McCabe CH, Cannon CP, et al. Cardiac-specific troponin I
levels to predict the risk of mortality in patients with acute
coronary syndrome. N Engl J Med 1996;335:1342–9.
Anderson JL, Adams CD, Antman EM, Bridges CR, Califf
RM, Casey DE Jr, et al. Guidelines for the management of
patients with unstable angina/non-ST-elevation myocardial
infarction. J Am Coll Cardiol 2007;50(7):e1–e157
Bertrand ME, Simoons CML, Fox KAA, Wallentin LC,
Hamm CW, McFadden E, et al. Recommendation of the
Task Force of the European Society of Cardiology on
management of Acute Coronary syndrome without STelevation. Eur Heart J 2000;21:1406–32.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.