Kan arbeidsbelastningstestens sensitivitet for myokardiskemi økes ved å måle myocyttmarkørene troponin-t, kreatinkinase-MB og myoglobin hos pasienter med koronarsykdom?

Abstract

ABSTRACT Background. The Electrocardiographic exercise stress test (EEST) is frequently used in patients with suspect coronary heart disease (CHD). However, its predictive value is poor. We aimed to investigate whether measurement of biochemical markers of myocardial injury induced by EEST could improve the diagnostic value of the procedure. Our second aim was to look at the relations between biochemical myocardial markers and the degree of CHD.

Material and methods. Sixty patients from the dietary intervention study “Fjord til Bord” also participated in this study. They were referred to Ullevål University Hospital with suspect CHD. A total of 56 patients completed our protocol. All went through coronary angiography, and at least six weeks later blood samples for TnT, CK-MB and myoglobin analysis were obtained before, and 15 minutes and one hour after EEST.

Results. EEST did not result in measureable elevation of the serum TnT or CK-MB in our patient group. A tendency to elevation in the myoglobin values was noted although not statistically significant. Coronary angiography was evaluated with two criteria, the degree of stenosis and how many vessels who were affected. We compaired the two criteria with measurements of serum TnT, CK-MB and myoglobin, and found no significant correlations.

Conclusions. The measurement of serum TnT, CK-MB and myoglobin in our patient group did not add to the diagnostic utility of the EEST. Nor did we find any relations between serum TnT, CK-MB, myoglobin and the degree of CHD.