Comparative Analysis of Abnormal Troponin and ST Deviations in Diagnosis of Myocardial Infarction

Abstract

Introduction: Troponin levels are vital for diagnosing myocardial infarction (MI) and assessing cardiac chest pain. While traditionally used for MI, elevated troponin is also observed in various cardiovascular and non-cardiovascular conditions. Recent research across Nigeria indicates an increasing trend in MI cases and coronary artery disease risk factors. This study aimed at examining the connection between troponin levels, ECG abnormalities, and causes of heightened troponin and abnormal ECG. Method: The study included 47 patients with elevated troponin levels from 1266 who underwent troponin testing at GoodHeart Medical Consultants Hospital between January 2018 and December 2022. ECG data were assessed, considering ST elevation or depression as present if the ST-segment sloped upward or downward for at least 0.08s in one or more of the 12 leads, excluding aVR. Results: All patients in the study had 100% compliance with ECG recordings and troponin measurements. The mean age was 61 ± 16.58 years, with 53% males and 47% females. Hypertensive heart disease affected 74.47% of the population. Over five years, abnormal troponin prevalence was 3.71% (n = 47/1266), with myocardial infarction prevalence at 46.81%. Among those with myocardial infarction, 72.73% showed ST elevation, 22.73% had ST depression, and 4.54% showed neither. Conclusion: The study demonstrated the complementary roles of cardiac troponin (cTn) status and quantitative ST deviation in assessing Acute Coronary Syndrome (ACS) patient risk, usable dependently or independently for prognosis. While both are valuable risk indicators, cTn proves more helpful than ST elevation in diagnosing non-ST-segment elevation myocardial infarction (NSTEMI).