SEVERITY OF CORONARY ARTERY DISEASE IN NON-ST ELEVATION MYOCARDIAL INFARCTION (NSTEMI) PATIENTS WITH HIGH TROPONIN-I LEVEL

Abstract

Objective: To determine the frequency of severity of obstructive coronary arterydisease or left main coronary artery stenosis in NSTEMI patients with elevatedTroponin-I level. Methodology: This cross-sectional study was conducted at National Institute ofCardiovascular Diseases (NICVD), Karachi from 25 January to 24 July 2015.Weincluded patients diagnosed with NSTEMI, between 40-72 years of age. Patientswere classified as low risk (Group A) and high risk (Group B) based on criteria ofelevated troponin I level more than tenfold the maximum threshold of the normalrange. Chi square test or Fisher's Exact test, Kruskal-Wallis Test, and independentsample t-test were applied as appropriate and two sided p 0.05 was used as acriterion for statistical significance. Results: Total 123 Patients were included. There were 95 (77.24%) malepatients. Mean age was 54.72±8.27 years. Of total 25(20.33%) of the patientswere in high risk group. Normal angiogram was observed in a significantly highnumber of lower risk group (Group A) as compared to higher risk group (GroupB), 13(13.27%) vs. 0(0%). SVD was observed in 35(35.71%) vs. 1(4%) ofpatients of lower risk group and higher risk group. (p = 0.001), 2VD wasobserved in 26(26.53%) vs. 12(48%) (p= 0.036) and 3VD was observed in24(24.49%) vs. 12(48%) (p=0.022). Conclusion: Elevated troponin I levels, more than tenfold of the maximumthreshold of the normal range, in non-ST elevated myocardial infarction(NSTEMI) patients are strongly associated with more complex and severecoronary artery disease. Key Words: Myocardial Infarction, NSTEMI, Angiography, Acute CoronarySyndrome, Troponin.