Sajid Ali Shaikh, Ghulam Abbas Shaikh, Musa Karim.
Severity of coronary artery disease in non-st elevation myocardial infarction (NSTEMI) patients with high troponin-i level.
Pak Heart J Jan ;51(2):114-8.

Objective: To determine the frequency of severity of obstructive coronary artery disease or left main coronary artery stenosis in NSTEMI patients with elevated Troponin-I level. Methodology: This cross-sectional study was conducted at National Institute of Cardiovascular Diseases (NICVD), Karachi from 25 January to 24 July 2015. We included patients diagnosed with NSTEMI, between 40-72 years of age. Patients were classified as low risk (Group A) and high risk (Group B) based on criteria of elevated troponin I level more than tenfold the maximum threshold of the normal range. Chi square test or Fisher`s Exact test, Kruskal-Wallis Test, and independent sample t-test were applied as appropriate and two sided p 0.05 was used as a criterion for statistical significance. Results: Total 123 Patients were included. There were 95 (77.24%) male patients. Mean age was 54.72+-8.27 years. Of total 25(20.33%) of the patients were in high risk group. Normal angiogram was observed in a significantly high number of lower risk group (Group A) as compared to higher risk group (Group B), 13(13.27%) vs. 0(0%). SVD was observed in 35(35.71%) vs. 1(4%) of patients of lower risk group and higher risk group. (p = 0.001), 2VD was observed in 26(26.53%) vs. 12(48%) (p= 0.036) and 3VD was observed in 24 (24.49%) vs. 12(48%) (p=0.022). Conclusion: Elevated troponin I levels, more than tenfold of the+-maximum threshold of the normal range, in non-ST elevated myocardial infarction (NSTEMI) patients are strongly associated with more complex and severe coronary artery disease.

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