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

Abstract

Objectives. In this study, we investigated the relationship between the rate of increase in troponinI 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 troponinI levels, which were determinedby serial measurements after 2, 4, and 6h 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 troponinI levels at time intervals of (02), (04), and (06)h and in-hospital major cardiovascular endpoints (p0.05). Conclusion. The analysis of delta troponinI 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.