Carotid atherosclerosis is associated to higher troponin levels during NSTE-ACS

Background and Aims:Acute coronary syndromes(ACS),in particularNSTEMI,are frequent among elderly patients admitted to internal andemergency medicine. Increased intima-media-thickness(IMT)andcarotid stenosis have been associated to a more severe coronary ar-tery disease in stable patients.Less is known of their value in ACS.Onthe contrary, Troponin I(TnI) levels have been related to infarct size andprognosis in this subset of patients. Methods:We enrolled 192 consecutive patients admitted to our de-partment with a definite diagnosis of NSTEMI. Each patient was in-vestigated evaluating sex, age, risk factors, chronic renal failure,presence of atrial fibrillation and troponin levels. Carotid ultrasoundwas performed within 24 hours from the admission, evaluating IMT orcarotid plaques. We performed a multivariate analysis to assess if IMTor carotid plaque could be associated to increased TnI levels at theadmission, correcting for risk factors, chronic renal failure, age, sexand creatinin clearance. Results:Increased IMT and the presence of a carotid plaque of anyseverity were independently related to increased TnI levels at admis-sion. The presence of a pathological IMT or a carotid plaque were as-sociated to a mean increase of TnI of 9.31 ng/ml (p <0.05) in respectto patients with normal neck vessels.Conclusions: Pathological IMT and carotid plaques are associated tohigher TnI levels at the admission. This observation, if confirmed inlarger studies, could be helpful to stratify NSTEMI patients with a moresevere prognosis.