Elevated admission cardiac troponin T is associated with microvascular dysfunction in acute myocardial infarction treated with emergency angioplasty

BACKGROUND: We speculated that elevated admission cardiac troponin T (cTnT) could predict worse microvascular function in patients with ST-elevation myocardial infarction who are managed with emergency percutaneous coronary intervention. METHODS: In 27 patients with ST-elevation myocardial infarction, we obtained admission cTnT, angiography at the time of intervention, and cardiovascular magnetic resonance after 3 days. RESULTS: Elevated admission cTnT was associated with a higher corrected Thrombolysis In Myocardial Infarction frame count (P = 0.04) and with a trend toward worse myocardial blush grade at the end of the procedure (P = 0.069), indicating a higher degree of microvascular obstruction. This was confirmed by its correlation with the size of perfusion defect seen at first-pass cardiovascular magnetic resonance (ρ = 0.42, P = 0.028). In contrast, admission cTnT did not correlate with the amount of muscle necrosis as seen by delayed-enhancement cardiovascular magnetic resonance (ρ = 0.12, P = 0.55). CONCLUSION: Elevated admission cTnT predicts worse microvascular function in ST-elevation myocardial infarction patients managed with emergency percutaneous coronary intervention. Measuring admission cTnT might provide the interventionalist with useful information for selecting additional therapies that benefit coronary microcirculation. © 2009 Italian Federation of Cardiology.