Prevalence and clinical predictors of myocardial injury in patients with acute supraventricular tachycardia

Myocardial injury without overt ischemia accounts for approximately 30% of all myocardial injury cases and is associated with worse outcomes, regardless of the underlying cause. Myocardial injury in patients following acute episodes of supraventricular tachycardia (SVT) has been observed in several small-sample studies. However, the precise relationship between myocardial injury and SVT remains unclear. In this retrospective, single-center study, we analyzed the data of 292 adult patients with acute SVT who presented to our emergency department between November 2019 and February 2024. Data on demographics, clinical characteristics, troponin values, and investigation outcomes were extracted from the electronic medical records. All 292 patients were divided into two groups based on their high-sensitivity cardiac troponin T (hs-cTnT) levels. Predictors of troponin level elevation were also assessed. Of the total participants, 148 (50.7%) were classified as hs-cTnT-positive, and 144 (49.3%) were classified as hs-cTnT-negative. Multivariate analysis revealed that hs-cTnT level elevation was independently associated with serum creatinine levels ( P < 0.001), initial heart rate ( P = 0.001), and the time since SVT onset ( P < 0.001). The area under the curve for this model was 0.824 ( P < 0.001), with a sensitivity of 78.4% and specificity of 74.3%. Myocardial injury was frequently observed during acute SVT. Serum creatinine levels, initial heart rate, and the time since SVT onset were identified as independent predictors of myocardial injury.