High sensitive troponin-I in patients with slow coronary flow pattern.

HYPOTHESIS We examined the hypothesis that a specific myocardial injury marker, namely high sensitive cardiac troponin-I (HsTn-I), is elevated in patients with slow coronary flow (SCF) pattern. AIM To examine the above hypothesis by studying a group of patients who had undergone coronary angiography for the detection of their chest pain aetiology with SCF pattern despite an angiographically normal coronary arteriogram. METHODS We evaluated and performed coronary angiography (CAG) of 97 patients with chest discomfort. The indication forCAG was at least Canada class 3 angina and/or proven myocardial ischaemia according to noninvasive diagnostic tests. We further divided patients into three subgroups according to CAG images and compared HsTn-I plasma levels in 39 patients with SCF pattern, 28 patients with coronary artery disease (CAD), and 30 patients with normal coronary arteries. We researched the association between qualitative HsTn-I positivity and demographic features including cardiovascular risk factors, inflammation markers and TIMI frame count for each of the epicardial coronary arteries. RESULTS TIMI frame count for each epicardial coronary artery was significantly higher in patients with SCF pattern than in patients with CAD and normal coronary arteries (p < 0.001). HsTn-I positivity was not statistically different between patients with SCF pattern and normal coronary arteries (p = 512), but it was significantly higher in the CAD group than the other two group of patients (p < 0.001). CONCLUSIONS In patients with SCF, HsTn-I may be detectable, but it is not elevated as in patients with normal coronary arteries.