Supraventricular tachycardia (SVT) and high troponin levels: patient characteristics and evaluation of coexisting coronary artery disease

Abstract Background High-sensitive troponin (hs-cTnI/hs-cTnT) assays are preferred for detecting myocardial injury and can be elevated in various clinical conditions other than acute myocardial infarction including supraventricular tachycardias (SVTs). Patients with SVT and troponinemia often need further evaluation for coronary artery disease (CAD), guiding the clinical management. Purpose The purpose of this study is to characterize patients with supraventricular tachycardia (atrioventricular nodal reentrant tachycardia-AVNRT, atrioventricular reentrant tachycardia-AVRT and atrial tachycardia-AT) and elevated troponin values as well as to evaluate the association between troponin increase and coexisting coronary artery disease. Methods We recorded demographic characteristics, main complaints, underlying comorbidities, presence or absence of a previous history of SVT, duration of tachycardia, systolic blood pressure (SBP), heart rate (HR), creatinine and peak hs-cTnI values on admission. Further details on the type of cardioversion and the total number of patients who visited the Emergency Department (ED) or were admitted to the Cardiology department due to SVT in the last 3 years were recorded. Subsequently, we examined all hospitalized patients, distinguishing those who underwent an invasive or non-invasive test to rule out CAD and noting the presence or absence of coexisting CAD. The patients were divided into two groups based on the presence of troponinemia. Data analysis using IBM-SPSS 27 and results presentation with mean and standard deviation for values with normal distribution and median and interquartile range (25th-75th) for values with non-normal distribution. Results Out of 106 patients who presented to the ED due to SVT 47 had abnormal hs-cTnI values. A statistically significant difference was observed in patients with troponinemia, particularly those with retrosternal pain, no previous history of SVT, and a longer duration of tachycardia. Factors such as gender, admission Cr, sodium, potassium, and SBP values, the presence of known CAD, diabetes mellitus (DM), thyroid disease, hypertension, or the type of cardioversion had no significant effect on the occurrence of troponinemia. Among the 47 patients with troponinemia, 39 were admitted to the Cardiology Department, and 21 of them underwent further evaluation for CAD, with only one patient showing significant disease. Conclusions Patients without a previous episode of SVT, presenting with retrosternal pain and longer duration of tachycardia on admission seem to be the ones to present abnormal troponin values after an episode of SVT. The occurrence of troponinemia in these patients is more likely to be related to myocardial oxygen-demand needs mismatch than to the presence of CAD. Comorbidities and other characteristics Admission values