Relationship between Initial High-Sensitivity Cardiac Troponin-T Morbidity and Mortality in Patients after ST-Elevation Myocardial Infarction in Erbil City, Iraq

Abstract

Background: ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous intervention (PPCI) are at a high risk of death and MACE (Major Adverse Cardiovascular Events). One method to stratify these patients’ risk could be high-sensitivity cardiac troponin-T (hs-cTnT). Unfortunately; data using this approach is limited. The aim of this study was to investigate whether there is a correlation between initial levels of cTnT in STEMI patients with MACE. Methods: Initial hs-cTnT levels were measured in 167 patients with STEMI undergoing PPCI. Patients were divided into 2 groups: group A hs-cTnT below the median (83 patients); group B hs-cTnT above the median (84 patients). Patients were followed up for 2 years investigating mortality and MACE. Results: The median value of initial hs-cTnT was 100 ng / L. The mean hs-cTnT was 52 ± 26 ng / L in group A and 548 ± 458 ng / L in group B. 18 (10.8%) patients died during follow-up:13 (15.5%) in group B compared to only 5 (6%) ingroup A (P < 0.05). Further analysis showed that non-surviving patients were older, more likely to be female, had more diabetes mellitus, more hypertension, and more diffuse coronary artery disease. They also had worse outcomes such as heart failure, increased rates of recurrent chest pain, readmissions and other infrequent complications such as complete heart block, renal impairment, reinfarction, stent thrombosis, and upper gastrointestinal tract bleeding. Conclusions: Increased initial hs-cTnT levels are associated with a higher risk of mortality and morbidity at 2-year follow up in patients from Erbil with STEMI undergoing PPCI.