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Predictive Value of High-Sensitivity Troponin I for Left Ventricular Ejection Fraction in Patients with
Tran Nguyen Phuong Hai1, Nguyen Minh Kha2,3, Do Nguyen Tuong Dat2
1Department of Interventional Cardiology, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
Insights
High-sensitivity cardiac troponin I (hs-cTnI) levels are inversely correlated with left ventricular ejection fraction (LVEF) in non-ST-elevation myocardial infarction (NSTEMI) patients. This biomarker helps predict left ventricular systolic dysfunction (LVSD), aiding early risk stratification and management.
Area of Science:
- Cardiology
- Biomarkers
- Diagnostic Medicine
Background:
- Cardiovascular diseases (CVDs), especially coronary artery disease (CAD), are leading causes of death globally, impacting both high-income and low-income nations.
- Acute myocardial infarction (AMI) significantly contributes to mortality and cardiovascular complications, particularly in patients with left ventricular systolic dysfunction (LVSD).
Purpose of the Study:
- To investigate the correlation between high-sensitivity cardiac troponin I (hs-cTnI) levels and left ventricular systolic dysfunction (LVSD) in patients with non-ST-elevation myocardial infarction (NSTEMI).
- To evaluate the predictive value of hs-cTnI for left ventricular ejection fraction (LVEF) in NSTEMI patients.
Main Methods:
- A descriptive, cross-sectional study involving 117 first-time NSTEMI patients.
- Measurement of admission hs-cTnI levels and assessment of LVEF via echocardiography.
- Receiver operating characteristic (ROC) curve analysis to determine the predictive value and optimal cut-off points of hs-cTnI for LVSD.
Main Results:
- A significant inverse correlation was observed between hs-cTnI levels and LVEF (r = -0.569, p < 0.001).
- Patients with moderate-to-severe LVSD (LVEF ≤ 40%) exhibited the highest median hs-cTnI levels (25,000 pg/mL).
- Optimal hs-cTnI cut-offs were identified for predicting LVEF < 50% (12,344 pg/mL) and LVEF ≤ 40% (20,979 pg/mL) with high accuracy.
Conclusions:
- Hs-cTnI is a reliable biomarker for predicting LVSD in NSTEMI patients.
- The inverse correlation between hs-cTnI and LVEF supports its use in risk stratification.
- Early identification of LVSD using hs-cTnI can inform management decisions for NSTEMI patients.
Background:
According to the World Health Organization's 2021 statistics, cardiovascular diseases (CVDs), particularly coronary artery disease (CAD), remain among the leading causes of global morbidity and mortality, affecting both high-income and low-income countries like Vietnam.
Objective:
Acute myocardial infarction (AMI) remains a major cause of mortality and cardiovascular complications, with a poor prognosis in patients with left ventricular systolic dysfunction (LVSD). High-sensitivity cardiac troponin I (hs-cTnI) is a specific biomarker of myocardial injury linked to infarct size and LVSD. However, its role in predicting left ventricular ejection fraction (LVEF) in non-ST-elevation myocardial infarction (NSTEMI) is underexplored. This study investigates the correlation between hs-cTnI and LVSD in NSTEMI patients.
Methods:
A descriptive, cross-sectional study was conducted on 117 patients with first-time NSTEMI treated at Cho Ray Hospital from February 2024 to April 2024. Admission hs-cTnI levels were measured and correlated with LVEF, assessed via echocardiography. The predictive value and optimal cut-off points of hs-cTnI for LVSD (LVEF < 50% and ≤ 40%) were determined using receiver operating characteristic (ROC) curve analysis.
Results:
Hs-cTnI levels showed a significant inverse correlation with LVEF (r = - 0.569, p < 0.001). Patients with moderate-to-severe LVSD (LVEF ≤ 40%) had the highest median hs-cTnI levels (25,000 pg/mL, p < 0.001). The area under the ROC curve (AUC) for predicting LVEF < 50% was 0.78, with a cut-off of 12,344 pg/mL (sensitivity 68.5%, specificity 82.5%). For LVEF ≤ 40%, the AUC was 0.82, with a cut-off of 20,979 pg/mL (sensitivity 73.3%, specificity 88.5%, accuracy 84.6%). These findings underscore hs-cTnI's utility in identifying LVSD.
Conclusion:
Hs-cTnI is inversely correlated with LVEF and serves as a reliable biomarker for predicting LVSD in NSTEMI patients, facilitating risk stratification and early management decisions.
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