Jisa George1, Malathy A.R.2
BACKGROUND
Cardiac biomarkers like troponin play a very important role in the diagnosis of
acute myocardial infarction. In a developing country like India, though the burden
of cardiovascular diseases is on the rise, majority of the patients with acute
coronary syndrome do not have access to primary percutaneous coronary
intervention (PCI) facilities. Few Indian studies have looked into the utility of the
quantitative troponin levels in predicting the cardiovascular outcome of non-ST
segment elevation myocardial infarction / ST segment elevation myocardial
infarction STEMI / NSTEMI patients; this study was conducted to find out the
same.
METHODS
A retrospective analysis of the medical records of intensive care units (ICU)
patients more than 18 years of age admitted with diagnosis of STEMI / NSTEMI
for a duration of 12 months was done. The comorbidities, treatment, coronary
artery disease (CAD) risk factors, cardiovascular complications and quantitative
troponin levels were noted.
RESULTS
Retrospective analysis of 124 patient records was done which revealed that 74.8
% presented with STEMI and the rest were diagnosed to have NSTEMI. 39.5 %
were hypertensive and 47 % were diabetic. The mean troponin values were higher
in the patients who died and developed cardiac complications like left ventricular
failure and cardiogenic shock. However, statistical significance was seen only for
troponin values and left ventricular failure (LVF).
CONCLUSIONS
The quantitative levels of a simple biomarker like troponin I used for the diagnosis
of acute myocardial infarction could also be used to predict the cardiovascular
outcome and prognosis of the patient. A higher baseline troponin value during the
diagnosis could possibly alert the treating primary physician for a referral to a
specialised cardiac centre and likely need for early revascularisation, which is of
importance in a developing country like India with compromised resources.
