325 Diagnostic and prognostic value of troponin elevation associated with symptomatic paroxysmal reentrant supraventricular tachycardia

BackgroundCardiac troponin is the gold standard for the diagnosis and risk stratification in acute coronary syndrome (ACS). Troponin elevation associated with symptomatic paroxysmal reentrant supraventricular tachycardia (PSVT) has been described in short series but long term prognosis has not been yet reported.Overall survival in patients with and without ACSThe aim of the present study was to evaluate the diagnostic and prognostic value of troponin I elevation following PSVT.Methods and resultsFrom January 2003 to September 2009, all consecutive patients (n=27, 52% females, median age 52 years) admitted for PSVT and troponin I elevation (mean 0.42μg/l, range: 0.19–5.9) were included.None of the patients had a history of CAD. Thirteen patients (48.1%) were current smokers and 9 (33.3%) had no cardiovascular risk factor. All patients had narrow QRS during PSVT and the aetiology was nodal reentrant tachycardia in all except for one patient with preexcitation morphology in sinus rhythm.Coronary angiogram has been performed in 25 patients. Twenty three had angiographically normal coronary arteries. A single vessel disease (coronary stenosis >50%) was found in 2 patients and maximal stress echocardiography was normal in both patients. Two patients who declined coronary angiogram had normal maximal stress echocardiography.During follow-up (median 43 months, range: 4–82), none of the patients experienced ACS or cardiac death. One of the patients died from cancer after 63 months of follow up. Recurrence of PSVT requiring medical intervention occurred in 4 (14.8%) patients, atrial fibrillation in 3 (11%) patients and radiofrequency catheter ablation of atrioventricular nodal reciprocating tachycardia had been performed in 5 (18.5%) patients.ConclusionsTroponin I elevation following PSVT is common, not related to obstructive CAD or plaque rupture and is not associated with adverse short and long term prognosis