Relationship Between Delta Troponin I Levels And In-Hospital Cardiovascular Endpoints In Acute ST Elevation Myocardial Infarction

Objectives. In this study, we investigated the relationship between the rate of increase in troponin I levels and in-hospital cardiovascular endpoints (outcomes) in patients with ST-elevation myocardial infarction (STEMI).

Methods. Eighty-four patients with acute STEMI who received thrombolytic treatment or who underwent primary percutaneous coronary intervention (PCI) were enrolled. After admission to hospital, delta troponin I levels, which were determinedby serial measurements after 2, 4, and 6 h of admission, and in-hospital major cardiovascular events were evaluated.

Results. There were 35 (41.7%) patients in the thrombolytic group and 49 (58.3%) patients in the primary PCI group. As major cardiovascular endpoints, death from cardiovascular events was seen in 7 (8.3%) patients, stroke/transient ischemic attack in 2 (2.4%), recurrent ischemia in 5 (6%), arrhythmia in 8 (9.5%), and urgent revascularization was performed in 5 (6%) cases. In patients with arrhythmia, ventricular fibrillation was seen in 3 (3.6%) patients, atrial fibrillation in 3 (3.6%), and ventricular tachycardia in 2 (2.4%) patients. The ventricular septal defect was observed only in 1 (1.2%) patient as a mechanical complication, and the patient underwent urgent surgery. The analysis of all patients and sub-groups of thrombolytic and primary PCI patients revealed no statistically significant difference between delta troponin I levels at time intervals of (0–2), (0–4), and (0–6) h and in-hospital major cardiovascular endpoints (p >0.05).

Conclusion. The analysis of delta troponin I levels is not a predicting factor of in-hospital endpoints (outcomes) in patients with STEMI treated by thrombolytic therapy or primary PCI. Randomized controlled studies with a larger study population are needed on this subject.