Association of Troponin-I Level on Admission with 6-month Clinical Consequences in Acute Coronary Syndrome Patients: A Preventive Approach in Patient Care

Cardiovascular diseases are the leading cause of mortality worldwide. Therefore, it is important to predict the future consequences of the disease in patients who have recovered.

We sought to determine the relationship between troponin-I level and 6-month clinical consequences (i.e., re-infarction, death, re-angiography and coronary artery bypass grafting) in patients with acute coronary syndrome (ACS).

This prospective cross-sectional study was performed among 60 patients with ACS admitted to Ayatollah Mousavi Hospital in Zanjan, Iran. The participants were chosen using the convenience sampling method. Troponin-I level in these patients was initially evaluated.  Afterwards, they were followed up for six months in terms of clinical consequences. A checklist was prepared to collect the required data. The receiver operating characteristic (ROC) analysis was conducted to determine the predictive power of high-sensitivity troponin I for the mentioned consequences. Iodine index was calculated to determine the cutoff point for this enzyme in order to predict the consequences.

In general, 66.2% of the participants were male and the mean age was 60.46 ± 12.78 years. We found that 21.2% of the participants experienced one of the four clinical consequences in the follow-up period of 6 months. The sub-curved surface was calculated to be 0.705 for the prediction of consequences. The cutoff point for the prediction of consequences was 32.5; the negative predictive value for the cutoff point was 32.5, which was equal to 89.8%.

Troponin-I has an acceptable predictive power to identify 6-month consequences of ACS. Moreover, considering the negative predictive value of troponin-I, it is recommended to use this biomarker in patients with ACS. In addition, healthcare providers should pay more attention to the follow-up of patients after discharge and design preventive programs.