In patients with idiopathic acute pericarditis, ST-segment elevation was observed in 93% of those with cardiac troponin I >1.5 ng/ml compared to 57% of those without (P<0.01).
Observational (n=69)
What is the relationship between serum cardiac troponin I levels and ST-segment elevation in patients with idiopathic acute pericarditis?
In patients with idiopathic acute pericarditis, elevated cardiac troponin I is frequently observed and is strongly associated with ST-segment elevation, particularly in younger patients with a recent infection.
Absolute Event Rate: 93% vs 57%
p-value: p=<0.01
OBJECTIVE: ST-segment elevation in acute pericarditis is believed to be caused by superficial myocardial inflammation or epicardial injury. We used cardiac troponin I, a sensitive and specific marker of myocardial injury, to assess myocardial lesions in idiopathic acute pericarditis and its relationship to ST-segment elevation. PATIENTS AND METHODS: Sixty-nine consecutive patients (53 men, 48+/-17 years) with idiopathic acute pericarditis were included. We used an enzymoimmunoflurometric method to measure serum cardiac troponin I on admission (myocardial infarction threshold was 1.5 ng. ml(-1)). RESULTS: Cardiac troponin I was detectable in 34 patients (49%) and was beyond the 1.5 ng. ml(-1)threshold in 15 (22%). Coronary angiography performed in seven of these 15 patients was normal in all of them. ST-segment elevation was observed in 93% of the patients with cardiac troponin I >1.5 ng. ml(-1)vs 57% of those without (P<0.01). Sensitivity of ST-segment elevation to detect myocardial injury was 93% and specificity 43%. Patients with a cardiac troponin I increase higher than 1.5 ng. ml(-1)were more likely to have had a recent infection (66% vs 31%;P=0.01) and were younger (37+/-14 vs 52+/-16 years;P=0.002). There was no significant relationship with other parameters such as pericardial friction rub, fever, PR segment abnormalities, echocardiographic findings or C-reactive protein. CONCLUSION: In patients with idiopathic acute pericarditis, an increase in cardiac troponin I is frequently observed, especially in younger patients and those with a recent infection. Although ST-segment elevation does not reliably indicate myocardial injury, a significant cardiac troponin I increase is only seen in these patients.
Éric Bonnefoy (Mon,) conducted a observational in Idiopathic acute pericarditis (n=69). Elevated cardiac troponin I (>1.5 ng/ml) vs. Normal cardiac troponin I (≤1.5 ng/ml) was evaluated on ST-segment elevation (p=<0.01). In patients with idiopathic acute pericarditis, ST-segment elevation was observed in 93% of those with cardiac troponin I >1.5 ng/ml compared to 57% of those without (P<0.01).