Estimation of Cardiac Troponin-T Levels in Acute Myocardial Infarction With Reference to Short-Term Prognosis

This study aimed to estimate the cardiac troponin-T (cTnT) levels in patients with acute myocardial infarction (AMI) to measure the short-term prognosis.

Sixty patients with symptoms of AMI within six hours of onset were included, and the prognostic significance of cTnT levels was evaluated to predict mortality, recurrent ischemic events, and heart failure. The diagnostic performance of cTnT was evaluated through sensitivity and specificity analysis based on the determined cut-off value. All participants underwent clinical evaluations, echocardiograms, and received thrombolytic therapy.

Among study participants, 45 patients were male (75%) and 15 were female (25%), and the mean age was 50.7±7.93 years. Cardiac troponin T was positive (cTnT >0.18 ng/mL) in 50 (83.34%) cases and negative in 10 (16.66%) cases. The mean cTnT levels were higher in patients who did not survive than those who did (2.92±1.43 vs 0.705±0.63 ng/mL). A cTnT levels between patients with and without recurrent angina shows a significant difference (1.9705±1.538 vs 0.82±0.915 ng/mL, p<0.001). A cTnT level of 0.22 ng/mL at presentation diagnosed AMI with a sensitivity of 76.92% and a negative predictive value (NPV) of 98.2%, and a specificity and positive predictive value (PPV) of 100% and 65.4%, respectively. A cut-off cTnT value of 2.2 ng/mL predicted mortality with a sensitivity of 76.92% and a negative predictive value (NPV) of 94%, and a specificity and positive predictive value (PPV) of 100% each. The multivariable analysis revealed several factors significantly associated with mortality: point-of-care cardiac troponin T ≥0.22 ng/mL (hazard ratio (HR): 1.95, 95% confidence interval (CI): 1.85-2.19), heart failure (HR: 1.85, 95% CI: 1.65-2.08), recurrent angina (HR: 1.38, 95% CI: 1.19-1.55), and reinfarction (HR: 1.04, 95% CI: 0.99-1.12).

Cardiac troponin T positivity at admission consistently correlated with decreased rates of reperfusion after thrombolysis and lower ejection fraction. Cardiac troponin-T levels at admission can be able to predict the short-term prognosis, mortality, recurrent ischemic events, and heart failure in patients with AMI.