Troponin Positive Acute Coronary Syndrome with and without Significant Stenosis on Coronary Angiography

Hilal AL-Ali, Mohammed; A. Farhan, Hassan

	Troponin Positive Acute Coronary Syndrome with and without Significant Stenosis on Coronary Angiography
Iraqi Postgraduate Medical Journal
Article 1, Volume 14, Issue 2, 2015, Pages 237-243 PDF (0 K)
Authors
Mohammed Hilal AL-Ali; Hassan A. Farhan
Abstract
ABSTRACT: BACKGROUND: Occasionally, coronary arteries without significant stenosis are observed during invasive treatment of acute coronary syndrome (ACS). OBJECTIVE: The aim was to study the frequency and to determine the most predictive factors of Troponin positive ACS without significant Stenosis on angiography. METHODS: The study involved one hundred twenty four patients admitted with Troponin positive ACS who underwent cardiac catheterization during hospitalization. The primary end-point was the estimation of coronary arteries without significant stenosis, and the secondary end-point was analysis of the most predisposing factors. In evaluating the primary end-point, the patients were divided into two groups according to the presence of ST elevation myocardial infarction (STEMI) or not. Also the patient who has no significant coronary artery Stenosis (< 50%) was subdivided to two groups: a- Myocardial Infarction with No critical lesion in Coronary angiogram (MINC) b- Normal coronary angiogram RESULTS: Overall, 20 patients (16%) had coronary arteries without significant lesions, from which 8 patients (6.4%) had MINC and 12 patients (9.6%) had normal coronary angiogram. The predictors were: female sex (P=0.008), age <45 years (P=0.001), and the absence of: diabetes (P=＜0.001), hypertension (P=0.005) and absence of ST-segment elevation (P=0.001). Furthermore absence of regional wall motion abnormality (RWMA) is considered as another predictors for non-significant coronary artery lesion (P=0.008). Also the angiographic analysis of all lesions revealed that single vessels CAD are the commonest finding in Group I patients (P= 0.02). We further analyzed a suspicious angiographic lesions by using QCA {18 lesions (14.5%)} and FFR {6 lesions (4.8%)} technique. CONCLUSION: Overall, patients with Troponin positive ACS had non- significant coronary artery Stenosis on angiography, and female sex, age <45 years and the absence of diabetes, hypertension, ST- segment elevation or RWMA were all associated with coronary angiography showing no significant stenosis.
Keywords
KEYWORD; acute coronary syndrome; angiography

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