Study on Correlation between Troponin-I Level with Left Ventricular Systolic Dysfunction after First Attack of Non-ST Segment Elevation Myocardial Infarction

Abstract

Background: Coronary Heart Disease (CHD) is the most common type of heart disease, and it has been identified as the single most important cause of early death in the developed world. It's critical to recognise a patient with ACS because the diagnosis prompts both triage and care. CHD is responsible for more than half of all cardiovascular incidence in individuals. cTnI is a myocardium-specific tissue marker that has proven to be a highly sensitive and specific marker for AMI. After an ACS, the best predictor of death is ventricular function. It is a myocardial damage marker that also offers information on systolic function, diagnosis, and prognosis.

Objective of the Study: The study sought to determine the effect of LVEF on elevated Troponin-I levels in patients experiencing their first attack of NSTEMI.

Method:  From December 2015 to November 2016, a cross-sectional analytical study was carried out in the cardiology department of Mymensingh Medical College Hospital. Considering inclusion and exclusion criteria, a total of 130 first-time NSTEMI patients were included. The sample population was divided into two groups: Group–I: Patients with first attack of NSTEMI with LVEF: <55%. Group–II: Patients with first attack of NSTEMI with LVEF: <55%. Then LVEF and Troponin-I levels were correlated using Pearson’s correlation coefficient test.

Result: In this study mean Troponin-I of group-I and group-II were 5.53±7.43 and 16.46±15.79 ng/ml respectively. It was statistically significant (p<0.05). The mean LVEF value of groups were 65.31±10.30% and 40.17±4.62% respectively. It was statistically significant (p < 0.05). Patients with a high Troponin-I level had a low LVEF, while those with a low Troponin-I level had a preserved LVEF, according to echocardiography. According to the findings, patients with highest level of Troponin-I had severe left ventricular systolic dysfunction (LVEF <35%) and vice versa-the patients with the lowest levels of Troponin-I had preserved systolic function (LVEF \(\ge\) 55%). It was also discovered in our research that the levels of Troponin-I had negative correlation with LVEF levels with medium strength of association (r= -0.5394, p=0.001). Our study also discovered that Troponin-I level \(\ge\)6.6 ng/ml is a very sensitive and specific marker for LV systolic dysfunction.

Conclusion: The research team was able to determine that the greater the Troponin-I level, the lower the LVEF level, and hence the more severe the LV systolic dysfunction in NSTEMI patients with their first attack.