Author + information
- José Pedro L. Nunes, MD⁎ ()
- ↵⁎Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernani Monteiro, 4200 Porto, Portugal
I read with great interest the recent paper by Newby et al. (1) on interpretation of troponin elevations. The investigators discuss a considerable variety of disease states but leave out an important cause of troponin elevation: aortic valve disease.
A decade ago, aortic valve disease patients were shown to frequently have elevated troponin I values (2). This finding was subsequently confirmed by Kupari et al. (3). Aortic valve disease may manifest itself through chest pain, and may be one of the causes for a false diagnosis of myocardial infarction. It is important to point out that, on the whole, the syndrome of chest pain, elevated troponin levels, but no significant coronary artery disease, is not a benign condition (4).
Apart from diagnostic considerations, troponin may also have prognostic significance in this context. Rosjo et al. (5) showed that elevated troponin levels had prognostic implications in patients with aortic valvular stenosis. Solberg et al. (6) studied symptomatic aortic stenosis patients and found that high-sensitive troponin T and N-terminal–brain natriuretic peptide predicted outcomes.
Troponin may therefore be an important biomarker in the evaluation of patients with aortic valve disease.
- American College of Cardiology Foundation
- Newby L.K.,
- Jesse R.L.,
- Babb J.D.,
- et al.