| Title | Role of serum troponin-I in identifying left ventricular ejection fraction of <or= 40% in patients with acute anterior ST Elevation Myocardial Infarction. | | Author(s) | Shaikh AH, Hanif B, Lakhani MS, Malik F, Qazi HA, Mujtaba I | | Institution | Department of Cardiology, Tabba Heart Institute, Karachi. ahsdr1977@yahoo.com | | Source | J Coll Physicians Surg Pak 2009 Sep; 19(9):544-7. | | Abstract | OBJECTIVE: To determine the serum levels of troponin-I in identifying left ventricular ejection fraction (LVEF) of <or= 40% in patients with first anterior ST Elevation Myocardial Infarction (STEMI).
STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: At the Tabba Heart Institute, Karachi, from May to November 2008.
METHODOLOGY: Consecutive patients presenting with first anterior STEMI were studied. Troponin-I concentration was measured by MEIA (microparticle enzyme immunoassay) method and LVEF was visually assessed. Analysis of relation between troponin-I levels and LVEF by the Receiver-Operator Characteristic (ROC) curve was performed to determine the cut off values of troponin-I in identifying LVEF of <or= 40% in patients, who had received streptokinase or undergone primary Percutaneous Coronary Intervention (PCI).
RESULTS: Out of the 90 patients studied, 50 patients received streptokinase and the remaining 40 patients underwent primary PCI. Mean age was 54.6 +/- 9 years and 82% were male. Troponin-I levels of > 63.5 ng/ml predicted LVEF of <or= 40% with a sensitivity of 94% and specificity of 97% in patients receiving streptokinase, whereas in patients undergoing primary PCI, troponin-I levels of > 87.5 ng/ml predicted LVEF < 40% with a sensitivity of 86% and specificity of 100%.
CONCLUSION: Troponin-I concentration of > 63.5 ng/ml and > 87.5 ng/ml can predict LVEF <or= 40% in patients treated with either streptokinase or primary PCI respectively for first anterior STEMI. Troponin-I can be used as a non-imaging tool to identify patients with LVEF <or= 40% who need early aggressive therapy. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19728937 |
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