Low-level elevations in high-sensitivity cardiac troponin predict obstructive coronary artery disease and revascularisation in rural patients with non-ST-elevation myocardial infarction referred for coronary angiography

Intern Med J. 2024 Jun;54(6):1035-1039. doi: 10.1111/imj.16412. Epub 2024 May 29.

Abstract

Rural patients with non-ST-elevation myocardial infarction (NSTEMI) are transferred to metropolitan hospitals for invasive coronary angiography (ICA). Yet, many do not have obstructive coronary artery disease (CAD). In this analysis of rural Western Australian patients transferred for ICA for NSTEMI, low-level elevations in high-sensitivity cardiac troponin (≤5× upper reference limit) were associated with less obstructive CAD and revascularisation. Along with other factors, this may help identify rural patients not requiring transfer for ICA.

Keywords: Australia; cardiovascular disease; coronary angiography; coronary artery disease; myocardial infarction; rural.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Coronary Angiography*
  • Coronary Artery Disease* / blood
  • Coronary Artery Disease* / diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Revascularization
  • Non-ST Elevated Myocardial Infarction* / blood
  • Non-ST Elevated Myocardial Infarction* / diagnostic imaging
  • Non-ST Elevated Myocardial Infarction* / therapy
  • Retrospective Studies
  • Rural Population*
  • Troponin / blood
  • Troponin I / blood
  • Western Australia / epidemiology

Substances

  • Biomarkers
  • Troponin
  • Troponin I