Previous studies showed that troponin blood levels may increase after exercise. In this
study we assessed whether, among patients admitted with suspected unstable angina, the
increase in high-sensitive troponin T (hs-TnT) levels after exercise stress test (EST) might
help identify those with obstructive coronary artery disease (CAD) and predict symptom
recurrence during short term follow-up.
Maximal treadmill EST was performed in 69 consecutive patients admitted to the emergency
room with a suspicion of unstable angina (acute chest pain but confirmed normal
serum levels of cardiac troponins) was measured before and 4 hours after EST. Coronary
angiography was performed in 22 patients (32.8%).
hs-TnT increased after EST compared to baseline in the whole population (from 0.84±0.65
to 1.17±0.87 ng/dL, p<0.001). The increase was similar in patients with positive (n = 14)
and negative (n = 55) EST (p = 0.72), and was also similar in patients with (n = 12) and without
(n = 10) obstructive CAD at angiography (p = 0.91). The achievement of a heart rate at
peak EST �85% of that predicted for age was the variable mainly associated with the post-
EST hs-TnT increase at multivariable linear regression analysis (p = 0.005). The change
after EST of hs-TnT did not predict the recurrence of symptoms or readmission for chest
pain at 6-month follow-up.
Our data show that hs-TnT increased after EST in patients with suspected unstable angina,
which seemed largely independent of most clinical and laboratory variables. Thus, hs-TnT
assessed after EST does not seem to be helpful to identify patients with obstructive CAD in
this kind of patients.