Correlation between Troponin I, N-terminal pro–B-type natriuretic peptide, and left ventricular ejection fraction in acute coronary syndrome patients with mortality

• Main Authors: Darshit Pansuriya, Vrushali Khadke, Arun Bahulikar, Deepak Phalgune
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Heart India
• Subjects: acute coronary syndrome; correlation; left ventricular ejection fraction; mortality; n-terminal pro–b-type natriuretic peptide; troponin i
• Online Access: http://www.heartindia.net/article.asp?issn=2321-449x;year=2021;volume=9;issue=1;spage=18;epage=23;aulast=Pansuriya

Background: Troponin I (Trop 1) and N-terminal pro–B-type natriuretic peptide (NT-ProBNP) can be a discerning marker for the patients presenting with symptoms of acute cardiac ischemia and risk of death. The present study was to find a correlation between NT-ProBNP, troponin 1, and left ventricular ejection fraction (LVEF) in acute coronary syndrome (ACS) patients with mortality. Methods: Ninety ACS patients >18 years of age were included for this prospective observational study. Each patient was subjected to detailed clinical history, clinical examination, Trop I, NT-ProBNP, and LVEF at the time of admission. The primary outcome measures were to study the correlation of NT-ProBNP and Trop I and LVEF at the time of admission with mortality, whereas the secondary outcome measure was to study LVEF after ACS up to 1 month. Medians of continuous variables of two groups and three groups were tested. Results: The median Trop 1 levels were 12.0, 378.0, and 2454.0 in patients of unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI), respectively (P = 0.001). The median NT-ProBNP levels were 1027.0, 1494.0, and 3728.5 in patients of UA, NSTEMI and STEMI, respectively (P = 0.002). The median Trop 1 levels were 5433.0, 627.5, and 92.0 in patients whose LVEF was <40%, 40%–50%, and >50%, respectively (P = 0.001). The median NT-ProBNP levels were 14,554.0, 2009.0, and 306.0 in patients whose LVEF was <40%, 40%–50%, and >50%, respectively (P = 0.001). The median Trop 1 levels were 11439.0 and 570.0 in patients who expired and survived, respectively (P = 0.001). The median NT-ProBNP levels were 21047.0 and 1869.5 in patients who expired and survived, respectively (P = 0.001). The median LVEF were 30.0 and 45.0 in patients who expired and survived, respectively (P = 0.001). Trop I showed a significant positive correlation (r = 0.636) with NT-ProBNP levels (P < 0.001). Conclusion: Trop I, NT-ProBNP, and LVEF at the time of admission are strong predictors of 1-month mortality in ACS.