Role of serum troponin-l in identifying left ventricular ejection fraction of Ayaz Hussain, Shaikh; Bashir, Hanif; Muhammad Shakir, Lakhani; Faiza, Malik; Hammad Ali, Qazi; Iqbal, Mujtaba. JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2009; 19 (9): 544-547 in English | IMEMR | ID: emr-101998

ABSTRACT

To determine the serum levels of troponin-l in identifying left ventricular ejection fraction [LVEF] of patients with first anterior ST Elevation Myocardial Infarction [STEMI]. Case series. At the Tabba Heart Institute, Karachi, from May to November 2008. Consecutive patients presenting with first anterior STEMI were studied. Troponin-l concentration was measured by MEIA [microparticle enzyme immunoassay] method and LVEF was visually assessed. Analysis of relation between troponin-l levels and LVEF by the Receiver-Operator Characteristic [ROC] curve was performed to determine the cut off values of troponin-l in identifying LVEF of <40% in patients, who had received streptokinase or undergone primary Percutaneous Coronary Intervention [PCI]. Out of the 90 patients studied, 50 patients received streptokinase and the remaining 40 patients underwent primary PCI. Mean age was 54.6 +/- 9 years and 82% were male. Troponin-l levels of > 63.5 ng/ml predicted LVEF of <40% with a sensitivity of 94% and specificity of 97% in patients receiving streptokinase, whereas in patients undergoing primary PCI, troponin-l levels of > 87.5 ng/ml predicted LVEF < /=40% with a sensitivity of 86% and specificity of 100%. Troponin-l concentration of > 63.5 ng/ml and > 87.5 ng/ml can predict LVEF patients treated with either streptokinase or primary PCI respectively for first anterior STEMI. Troponin-l can be used as a non-imaging tool to identify patients with LVEF who need early aggressive therapy