Janorkar S, Koning R, Eltchaninoff H, Andres H, Lavoinne A, Cribier A
Department of Cardiology, Rouen University Hospital, France.
Indian Heart J. 1999 Jan-Feb;51(1):31-4.
This study sought to find out a correlation, if any, between serum cardiac troponin I values and extent and severity of coronary artery disease in patients with unstable angina. Eighty patients with unstable angina and normal serum creatine kinase values were studied and a comparative evaluation of serum cardiac troponin I values with clinical findings, electrocardiography, quantitative coronary angiography and follow-up events was performed. Among 80 patients, 34 (43%) had cardiac troponin I values of 0.6 microgram/L or higher (group I) and 46 (57%), below 0.6 microgram/L (group II). The mean cardiac troponin I in group I was 2.6 +/- 1.7 micrograms/L and 0.2 +/- 0.1 microgram/L in group II. The patients in group I had more type C lesions, frequent triple vessel and left main coronary artery involvement, and higher mean percentage diameter stenosis in the coronary arteries than those in group II. Early follow-up showed that more patients in group I required procedures earlier (including PTCA and CABG) than those from group II. Mid-term follow-up (9.5 +/- 4 months) data also showed greater occurrence of cardiac events (i.e. myocardial infarction and the increased need of PTCA) in group I. Patients with elevated cardiac troponin I more often experienced Braunwald's class III (A and B) unstable angina associated with presence of marked ST-T changes on the electrocardiography than those from group II. Our study suggests elevated values of serum cardiac troponin I to be evenly associated with the severity and extent of coronary lesions, clinical severity of unstable angina and marked electrocardiographic changes. Follow-up results confirm the potential value of this marker in predicting the course of coronary artery disease.
本研究旨在探寻血清心肌肌钙蛋白I值与不稳定型心绞痛患者冠状动脉疾病的范围及严重程度之间是否存在相关性（若有）。对80例血清肌酸激酶值正常的不稳定型心绞痛患者进行了研究，并对血清心肌肌钙蛋白I值与临床表现、心电图、定量冠状动脉造影及随访事件进行了比较评估。80例患者中，34例（43%）心肌肌钙蛋白I值为0.6微克/升或更高（I组），46例（57%）低于0.6微克/升（II组）。I组心肌肌钙蛋白I的平均值为2.6±1.7微克/升，II组为0.2±0.1微克/升。I组患者较II组患者有更多的C型病变、更频繁的三支血管及左主干冠状动脉受累，且冠状动脉平均直径狭窄百分比更高。早期随访显示，I组中需要更早进行手术（包括经皮冠状动脉腔内血管成形术和冠状动脉旁路移植术）的患者比II组更多。中期随访（9.5±4个月）数据也显示，I组心脏事件（即心肌梗死和经皮冠状动脉腔内血管成形术需求增加）的发生率更高。与II组患者相比，心肌肌钙蛋白I升高的患者更常出现与心电图上明显ST-T改变相关的Braunwald III级（A和B）不稳定型心绞痛。我们的研究表明，血清心肌肌钙蛋白I值升高与冠状动脉病变的严重程度和范围、不稳定型心绞痛的临床严重程度及明显的心电图改变均密切相关。随访结果证实了该标志物在预测冠状动脉疾病病程中的潜在价值。
