Abstract 14920: Elevation in Troponin-I is Associated With the Presence of Coronary Artery Disease and Increased Mortality in New Onset Atrial Fibrillation
Introduction: Patients with new-onset atrial fibrillation (AF) present with a range of symptoms including chest discomfort or dyspnea. Troponin-I (Tn-I) is occasionally elevated in the absence of other evidence of acute coronary syndrome (ACS). The correlation of Tn-I with underlying CAD in this setting is incompletely defined.
Hypothesis: Tn-I elevation in new-onset AF is associated with underlying CAD and worse outcomes.
Methods: This is a retrospective cohort of patients admitted with an initial episode of AF. Exclusion criteria were primary ACS or history of AF, CAD, heart failure or myocarditis. Patients (n=100) with admission Tn-I > 99th percentile were propensity matched to 89 patients without Tn-I elevation and compared for all cause mortality and subsequent diagnosis of CAD.
Results: Patient demographics are presented in the table. CAD was evaluated with non-invasive tests or angiography in 102 (54%). On multivariate analysis (see table), Tn-I ≥ 0.7 was associated with CAD (OR 6.4, p=0.006). All-cause mortality was increased with any Tn-I elevation (p = 0.032).
Conclusions: Patients with new-onset AF and a Tn-I level of ≥ 0.7 ng/mL are likely to have underlying CAD and further evaluation should be considered. Any Tn-I elevation is associated with higher mortality.
Author Disclosures: D. Hillerson: None. A. Karve: None. W.F. Armstrong: None.
- © 2016 by American Heart Association, Inc.