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Scholars Journal of Applied Medical Sciences | Volume-8 | Issue-03
“Cardiac Troponin I Level in STEMI and Clinical Correlation with Left Ventricular Dysfunction in Bangladeshi Population”
Md. Abul Kalam Azad, Kofil Uddin, Lakshman Chandra Barai, Bijon Kumar Saha, Md. Anisul Goni Khan, Mohammad Nizamul Hossain Sowdagar, Mohammad Harun-Ur-Rashid Khan, Biplab Kumar Das
Published: March 19, 2020 | 124 95
DOI: 10.36347/sjams.2020.v08i03.030
Pages: 953-960
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Abstract
Background: Coronary Heart Disease (CHD) is the most common category of the heart disease and is found to be the single most important cause that leads to premature death in the developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has shown itself as a very sensitive and specific marker for AMI. Objective: To determine the relationship of serum troponin I after first acute myocardial infarction with left ventricular ejection fraction as assessed by echocardiography. Methods: A total of 40 patients of acute myocardial infarction were included in the study. Troponin I concentration was measured by ELISA method and echocardiographic ejection fraction was calculated by modified Simpson’s rule. Echocardiographic ejection fraction was compared with serum troponin I concentration. Patients with previous myocardial infarction were excluded. Results: There was strong negative correlation between troponin I concentration and left ventricular ejection fraction with an increasing troponin level, there was a fall in ejection fraction. The Pearson’s correlation coefficient was –0.69, which was statistically significant (p<0.0001). In our study, we observed that patients with ejection fraction >50%, though small in number were having cTnI levels at 24 hrs ≤ 8 ng/ml. Patients with ejection fraction <50% (left ventricular systolic dysfunction) were having cTnI levels at 24 hrs ≥ 17 ng/ml. Therefore a presumptive cut off level of cTnI ≤ 8 ng/ml may be taken to consider normal left ventricular systolic function in STEMI. The normal range of Troponin I in apparently health individual without STEMI was observed to be <1.0 ng/ml. The mild increase in Troponin I at 24 hrs of STEMI with preserved EF >50% may be due to peak value of biomarker achieved at 24-36 hrs after myocardial injury as most of troponin I are attached to myofibrils. Conclusion: Serum troponin I .....