Shaukat Ali, Nadeem Hayat Mallick, Syed Faizul Hassan Rizvi.
Length of coronary stenosis in patients with unstable angina with elevated versus non-elevated troponin T-levels.
J Sheikh Zayed Med Coll Jan ;1(1):2-6.

Background: Cardiac troponin T elevation had a strong association with the presence of severe and complex coronary artery disease. Objective: To determine the length of coronary stenosis on angiogram in patients with unstable angina having elevated versus non-elevated troponin T-levels. Methods: Two hundred ten consecutive patients admitted at Punjab Institute of Cardiology, Lahore with clinical diagnosis of unstable angina were enrolled. Serum samples for troponin T were obtained 6 to 12 hours after onset of chest pain. Patients were grouped into positive and negative depending on troponin T levels (cut off value was 0.10ng/ml). All patients underwent Coronary angiography before discharge. Angiographic films were reviewed to determine the length of lesions. 200 patients had positive angiogram and 10 patients had no significant coronary artery disease. Length of coronary stenosis was described as discrete, tubular and diffuse according to ACC/AHA criteria. Results: Total number of patients were 210 with mean age of 53.3, ± SD 10.49. Male were 79% (165) and female were 21% (45). 71% were troponin positive and 29% were negative. Length of coronary stenosis in positive versus negative troponin T were discrete lesions 6.0% vs 33.3%, tubular 59.3% vs 48.3% and diffuse was 30.7% vs 11.7% (P< 0.01). Conclusion: Our study has demonstrated that unstable angina patients with raised troponin T had severe angiographic coronary artery stenosis, tubular and diffuse lesions comparing patients with negative troponin T levels. Therefore, troponin T positive patients should be evaluated by coronary angiography to determine the extent and severity of coronary lesions.

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