Frequency of elevated high-sensitivity troponin T and associated cardiac predictors in high-grade atrioventricular block patients with non-ischemic ECG changes

To assess the frequency of raised hs-TnT levels in patients with non-ischemic high-grade atrioventricular (AV) blocks and also to assess the cardiac risk factors in these patients. Study Design: Prospective, cross-sectional analytical study. Place and Duration of Study: This study conducted in the emergency department of Punjab Institute of cardiology, Lahore Pakistan, from Mar 2017 to Jun 2018. Patients and Methods: Patients with advanced 2nd degree and 3rd degree AV blocks, diagnosed on a 12-lead electrocardiogram (ECG), and no ischemic changes on the ECG were included. hs-TnT levels were done for all patients. All patients filled a preformed questionnaire. Data were entered and analyzed using IBM-SPSS-23. Results: Of the 138 patients recruited, 60.9% were male patients. The mean age of the study participants was 63.13 ± 14.73 years. Syncope was the most common presentation (78.3%). hs-TnT levels were elevated in 55.8% participants. Elevated Trop T levels were more common in male patients (63.6%). Elevated Trop T levels were significantly associated with co-morbidities including diabetes, hypertension, and smoking, and clinical presence of chest pain and syncope (p>0.05). Conclusion: Patients with non-ischemic high-grade AV blocks present with syncope. Even in absence of ischemia, troponin levels were seen in many participants. Elevated Trop T levels cannot be considered pathognomonic for myocardial ischemia. (author)