Cardiac Troponin I Level in STEMI and Clinical Correlation with Left Ventricular Dysfunction in Indian Population
|Department of Biochemistry1, Department of Medicine2 India Rajnish Singh3, Department of Cardiology4, India M. Imteyaz Ahmad1*|
|1Department of Biochemistry, PGIMER and Dr. Ram Manohar Lohia Hospital, New Delhi, India Neera Sharma|
|2Department of Medicine, PGIMER and Dr. Ram Manohar Lohia Hospital, New Delhi, India A.K Varshney|
|3Department of Medicine, PGIMER and Dr. Ram Manohar Lohia Hospital, New Delhi, India Rajnish Singh|
|4Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, New Delhi, India Ranjit Kumar Nath|
|Corresponding Author :||Dr. M. Imteyaz Ahmad
Department of Biochemistry, Nursing Home Laboratory
Room no.20, Dr. Ram Manohar Lohia Hospital
Baba Kharak Singh Marg, New Delhi, India Pin: 110001
E-mail: [email protected]
|Received June 29, 2013; Accepted July 30, 2013; Published August 06, 2013|
|Citation: Ahmad MI, Yadaw BK, Sharma N, Varshney AK, Sharma L, et al. (2013) Cardiac Troponin I Level in STEMI and Clinical Correlation with Left Ventricular Dysfunction in Indian Population. J Cardiovasc Dis Diagn 1:116. doi: 10.4172/2329-9517.1000116|
|Copyright: © 2013 Ahmad MI, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: To determine the relationship of serum troponin I after first acute myocardial infarction with left ventricular ejection fraction as assessed by echocardiography.
Methods: A total of 40 patients of acute myocardial infarction were included in the study. Troponin I concentration was measured by ELISA method and echocardiographic ejection fraction was calculated by modified Simpson’s rule. Echocardiographic ejection fraction was compared with serum troponin I concentration. Patients with previous myocardial infarction were excluded.
Result: There was strong negative correlation between troponin I concentration and left ventricular ejection fraction, i.e., with an increasing troponin level, there was a fall in ejection fraction. The Pearson’s correlation coefficient was –0.69, which was statistically significant (p<0.0001). In our study, we observed that patients with ejection fraction >50%, though small in number were having cTnI levels at 24 hrs ≤ 8 ng/ml. Patients with ejection fraction <50% (left ventricular systolic dysfunction) were having cTnI levels at 24 hrs ≥ 17 ng/ml. Therefore a presumptive cut off level of cTnI ≤ 8 ng/ml may be taken to consider normal left ventricular systolic function in STEMI. The normal range of Troponin I in apparently health individual without STEMI was observed to be <1.0 ng/ml. The mild increase in Troponin I at 24 hrs of STEMI with preserved EF >50% may be due to peak value of biomarker achieved at 24-36 hrs after myocardial injury as most of troponin I are attached to myofibrils.
Conclusion: Serum troponin I concentration has a strong negative correlation with left ventricular ejection fraction after first acute myocardial infarction, and hence can be used to assess the LVEF in patients with first myocardial infarction. An observation was made that a cut off level of cTnI ≤ 8 ng/ml was associated with normal left ventricular systolic function.