Troponin release overestimates infarct size in presence of left ventricular hypertrophy
Fernández-Jiménez R, López-Romero P, Suárez-Barrientos A, García-Rubira JC, Fernández-Ortiz A, Fuster V, Macaya C, Ibañez B.
To the Editor:
After an acute myocardial infarction (AMI), infarct size quantification is of clinical importance because it correlates with postinfarction mortality and morbidity (1). The gold standard in vivo techniques for infarct size quantification are magnetic resonance imaging and single-photon emission computed tomography; however, these methods are not universally available.
Systemic determination of both peak and area under the curve of circulating concentrations of creatine kinase (CK) and troponins positively correlate with infarct size as measured by using the gold standard techniques (2).
It has also been demonstrated that single time-point troponin concentration displays a strong correlation with infarct size (2,3). Circulating levels of necrosis biomarkers not only correlate with infarct size and ejection fraction but also predict clinical outcomes after a ST-segment elevation myocardial infarction (STEMI) (2).
As a result, infarct size is frequently assessed by using systemic biomarkers release, both in daily practice and in clinical trials.
CITATION J Am Coll Cardiol. 2012 Aug 14;60(7):640-1. doi: 10.1016/j.jacc.2012.02.067. Epub 2012 Jun 27