Initial troponin level may predict thrombus burden in patients with acute coronary syndrome. Optical coherence tomography study

Abstract

Background: The major cause of acute coronary syndrome (ACS) is vessel thrombosis related to plaque rupture. Optical coherence tomography (OCT) is a feasible and effective technique to visualise a thrombus in vivo.
Aim: To present the relationship between cardiac enzymes leakage before coronary angioplasty and thrombus visualised by OCT.
Methods: A population of 48 consecutive patients (mean age 64.8 ± 9 years) with non ST elevation syndromes treated with primary coronary angioplasty was selected for the study. Angiographic and OCT quantitative assessment was performed for all patients, as well as qualitative thrombus assessment with a new index — the thrombus score (TS). Troponin I and creatine kinase and its MB fraction were measured for all patients at baseline and at least 6–8 hours after coronary angioplasty.
Results: The troponin level assessed before coronary angioplasty was 3.42 ± 7.31 ng/dL. The mean TS assessed before coronary angioplasty was 96 ± 56, and in 17 (35.4%) patients the score was greater than 100 points. Mean artery length occupied by thrombus was 7.8 ± 3.8 mm. There was a significant correlation between troponin level and thrombus score (r = 0.44, p < 0.05) in the whole studied population.
Conclusions: Initial troponin level may be associated with larger thrombus burden within a coronary artery. This finding may influence coronary flow and needs to taken into consideration during primary coronary intervention.