Clinical profile of patients with acute coronary syndrome and its association with biomarker troponin I

Authors

  • Hemant S. Joshi Department of Neurology, Smt. B. K. Shah Medical Institute and Research Centre and Dhiraj Hospital, Waghodia, Vadodara, Gujrat, India
  • Samil Sajal Department of Medicine, Pacific Medical College and Hospital, Udaipur, Rajasthan, India
  • Nirmit V. Yagnik Department of Medicine, Smt. B. K. Shah Medical Institute and Research Centre and Dhiraj Hospital, Waghodia, Vadodara, Gujrat, India
  • Y. K. Bolya Department of Medicine, Pacific Medical College and Hospital, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20181084

Keywords:

Cardiac troponin, Chest pain, Dyslipidaemia, Recurrent angina

Abstract

Background: In patients with acute coronary syndromes, it is desirable to identify a sensitive serum marker that is closely related to the degree of myocardial damage, provides prognostic information, and can be measured rapidly. Author studied the clinical profile of patients with Acute MI and its relation with troponin I level.

Methods: In this prospective study, 65 patients admitted with Acute MI were studied. Study patients were divided in Troponin I positive and Troponin I negative group. Patients were followed up to discharge or death in the hospital.

Results: Most common symptom present in the patients with Acute Coronary Syndrome was chest pain (94%) and most common risk factor was dyslipidaemia (72.3%). Most common complication was recurrent angina (72.3%). Out of total patients with significant CAD, almost 70 % belong to Troponin I positive group and it is statistically highly significant (p<0.05). Total 30 patients (46.2%) have more than 10 episodes of angina in our study. There is statistically significant association between number of angina episode and Troponin I positivity (p<0.05). Out of total deaths, 73.3% have occurred among Troponin I positive study patients and it is statistically significant (p<0.05).

Conclusions: In patients with acute coronary syndromes, cardiac troponin I levels provide useful prognostic information and permit the early identification of patients with an increased risk of death.

 

References

Facts about cardiovascular diseases. World Health Organization, 2007. Available at: http://www.who.int/mediacentre/factsheets/fs317/en/index.html.

Yang Z, Zhou DM. Cardiac markers and their point-of-care testing for diagnosis of Acute myocardial infarction. Clin Biochem. 2006;39:771-80.

McDonnell B, Hearty S, Leonard P, O’ Kennedy R. Cardiac biomarkers and the case for point-of-care testing. Clin Biochem. 2009;42:549-61.

Suprun E, Bulko T, Lisitsa A, Gnedenko O, Ivanov A, Shumyantseva V, et al. Electrochemical nanobiosensor for express diagnosis of acute myocardial infarction in undiluted plasma. Biosens Bioelectron. 2010;25:1694-8.

Yusuf S, Pearson M, Sterry H, Parish S, Ramsdale D, Rossi P, et al. The entry ECG in the early diagnosis and prognostic stratification of patients with suspected acute myocardial infarction. Eur Heart J. 1984;5:690-6.

Foy SG, Kennedy ICS, Ikram H, Low CJS, Shirlaw TM, Crozier IG. The early diagnosis of acute myocardial-infarction. ANZ J Med. 1991;21:335-7.

Stubbs P, Collinson PO. Point-of-care testing: A cardiologist’s view. Clin Chim Acta. 2001;311:57-61.

Kost GJ, Tran NK. Point-of-care testing and cardiac biomarkers: the standard of care and vision for chest pain centers. Card Clin. 2005;23:467-90.

Wan ZF, Yang LY, Sun P, Ren LL, Li ML, Wu H, Wang JF Zhang L. Conjugation of biomolecules with magnetic protein microspheres for the assay of early biomarkers associated with acute myocardial infarction. Anal Chem. 2009;81:6210-7.

Bottenus D, Jubery TZ, Ouyang YX, Dong WJ, Dutta P, Ivory CF. 10000-fold concentration increase of the biomarker cardiac troponin in a reducing union microfluidic chip using cationic isotachophoresis. Lab chip. 2011;11:890-160.

Panteghini M, Pagani F, Yeo KTJ, Apple FS, Christenson RH, Dati F, Mair J, Ravkilde J, Wu AHB. Evaluation of imprecision for cardiac troponin assays at low-range concentrations. Clin Chem. 2004;50:327-32.

Sasse S, Brand NJ, Kyprianou P, Dhoot GK, Wade R, Arai M, et al. Troponin I gene expression during human cardiac development and in end stage heart failure. Circ Res.1993;72:932-8.

Vichairuangthum K, Leowattana W, Ajyooth LO, Pokum S. The relationship between serum concentration of cardiac troponin I in chronic renal failure patients and cardiovascular events. J Med Assoc Thail. 2006;89:714-20.

Mahajan VS, Jarolim P. How to interpret elevated cardiac troponin levels Circulation. 2011;124:2350-4.

Thygesen K, Alpert JS, Jaffe AS. Third universal definition of myocardial infarction. Eur Heart J. 2012;33:2551-67.

Kavsak PA, MacRae AR, Lustig V. The impact of the ESC/ACC redefinition of myocardial infarction and new sensitive troponin assays on the frequency of acute myocardial infarction. Am Heart J. 2006;152:118-25.

Heeschen C, Hamm CW, Goldmann B, Deu A, Langenbrink L, White HD. Troponin concentrations for stratification of patients with acute coronary syndromes in relation to therapeutic efficacy of tirofiban. PRISM Study Investigators. Platelet Receptor Inhibition in Ischemic Syndrome Management. Lancet. 1999;354:1757-62.

Janorkar S, Koning R, Eltchaninoff H, Andres H, Lavoinne A, Cribier A. Relation between serum cardiac troponin I values and severity of clinical, electrocardiographic and quantitative angiographic features inunstable angina. Indian Heart J. 1999;51:31-4.

Roe MT, Peterson ED, Li Y, Pollack CV, Christenson RH, Peacock WF, et al. Relationship between risk stratification by cardiac troponin level and adherence to guidelines for non ST-segment elevation acute coronary syndromes. Archives of Internal Medicine. 2005 Sep 12;165(16):1870-6.

Keller T, Zeller T, Peetz D, Tzikas S, Roth A, Czyz E, et al. Sensitive troponin I assay in early diagnosis of acute myocardial infarction. New England J Med. 2009 Aug 27;361(9):868-77.

Luscher MS, Thygesen K, Ravkilde J, Heickendorff L. Applicability of cardiac troponin T and I for early risk stratification in unstable coronary artery disease. TRIM Study Group. Thrombin Inhibition in Myocardial Ischemia. Circulation. 1997;96:2578-85.

Mathew T, Menown I, Smith B. Diagnosis and risk stratification of patients with anginal pain and non-diagnostic electrocardiograms. QJM. 1999;92:565-71.

Maqsood A, Kaid K, Cohen M. Clinical significance of borderline cardiac troponin (CTNI) in patients presenting with acute coronary syndrome who are referred for cardiac catheterization. The Internet Journal of Cardiovascular Research. 2006;4:1-4.

Eggers KM, Lagerqvist B, Venge P, Wallentin L, Lindahl B. Persistent cardiac troponin I elevation in stabilized patients after an episode of acute coronary syndrome predicts long-term mortality. Circulation. 2007 Oct 23;116(17):1907-14.

Meyer T, Binder L, Graeber T. Superiority of combined CK-MB and troponin I measurements for the early risk stratification of unselected patients presenting with acute chest pain. Cardiol. 1998;90:286-94.

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Published

2018-03-21

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Original Research Articles