Association of Troponin levels with angiographic findings among patients with non-ST segment elevation myocardial infarction

Introduction The assessment of Troponin levels at admission is essential for risk stratification of non-ST-segment elevation myocardial infarction (NSTEMI) and estimation of infarct size. Objective The aim of this study is to confirm whether the troponin level at admission can predict the angiographic severity of coronary artery disease (CAD) regarding NSTEMI patients. Method A retrospective study of 81 patients with NSTEMI hospitalized in the Intensive Cardiac Unit of the Cardiology Department of AVERROES Hospital, Casablanca. All the patients had cardiac biomarker assessment and were scheduled for coronary angiography. ACC/AHA classification was used to determine the anatomical complexity of CAD. Results Mean age was 59.3 years, and most patients were male (70.4%). Thirty-four patients were chronic smoker while 7 patients were weaned tobacco user. Forty-two percent were hypertensive while 25.9% of the patients were diabetic. Seventy-five patients had coronary angiography. The others did not because of complications (stroke, hemodynamically unstable AF). Among the patients, 59.3% had coronary artery angioplasty, 11.1% were scheduled for coronary artery bypass grafting, while medical treatment was decided for the rest of patients. Mean heartbeat was 78.5 bpm and mean arterial pressure was 120/70 mmHg. Mean left ventricular ejection fraction was 52%. Mean troponin level was 9718 ng/mL. Troponin level in patients presenting with simple CAD was 1317 ng/mL versus 15,342 ng/mL in patients with complex CAD. Positive linear correlation was found between the hsTn levels and the complexity of CAD (P = 0.041). Conclusion Troponin level at admission may predict the complexity of CAD. In our series, high hsTn were associated either with multivessel disease, LM or proximal LAD significant stenosis.