Correlation between Admission High-Sensitivity Cardiac Troponin and Angiographic Severity Assessed by the SYNTAX Score in Patients with Non-ST-Elevation Myocardial Infarction

Abstract

Objectives: Risk stratification is fundamental to the management of patients presenting with non-ST-elevation myocardial infarction (NSTEMI). Although high-sensitivity cardiac troponin (hs-cTn) is the cornerstone biomarker for diagnosing myocardial infarction, its association with the anatomical complexity of coronary artery disease remains incompletely understood. This study aimed to determine the correlation between admission hs-cTn levels and angiographic severity assessed using the SYNTAX score in patients with NSTEMI. Methodology: This analytical cross-sectional study included sixty adult patients with confirmed NSTEMI were enrolled using non-probability consecutive sampling. Admission hs-cTn concentrations were measured before coronary angiography, which was performed within 72 hours of hospital admission. Coronary lesion complexity was evaluated using the SYNTAX scoring system. Pearson correlation analysis was used to determine the relationship between hs-cTn and SYNTAX score. Results: The mean age of participants was 50.86 ± 7.46 years, with a mean admission hs-cTn concentration of 187.52 ± 52.38 ng/L and a mean SYNTAX score of 24.34 ± 7.31. Admission hs-cTn demonstrated a statistically significant moderate positive correlation with the SYNTAX score (r = 0.452, p < 0.001). Mean hs-cTn concentrations differed significantly across low-, intermediate-, and high-SYNTAX score groups (F(2,57) = 4.72, p = 0.013). After adjustment for major cardiovascular risk factors, admission hs-cTn remained independently associated with angiographic disease complexity (Adjusted B = 0.652 per 10 ng/L increase, p = 0.001). Conclusion: Admission high-sensitivity cardiac troponin demonstrated a moderate positive correlation and independent association with angiographic severity assessed by the SYNTAX score in patients with NSTEMI.