THE INFLUENCE OF TROPONIN I IN IMPROVING THE ACCURACY IN THE DIAGNOSIS OF MYOCARDIAL INFARCTION COMPLICATIONS IN A GEOGRAPHICALLY DEFINED STEMI POPULATION
Abstract:
The third universal definition of AMI (acute myocardial infarction) in 2012 emphasizes the role of biomarkers in this situation. The objective of our study was to assess the significance of TnI in improving diagnostic accuracy and prognosis in a population - IMASST (ST segment elevation myocardial infarction) in Arges County. We retrospectively studied a cohort of 1,008 patients with STEMI admitted to the USTACC clinic, between January 1 2009-31 May 2013 with the following locations: anteriorly 38.79 %, inferiorly 30.06 %, laterally 12.70 %, posteriorly 3.77 % and associated 14.68 %. We stratified the cohort according to the following criteria: clinical (pain or equivalent), ECG (area under the ST in the relevant branch), biomarkers (TnI - troponin I), echocardiography and we followed the correlation of these parameters both in the diagnosis of STEMI, and regarding the following six events: thrombolysis, PCI (percutaneous coronary intervention), CABG (aortocoronary bypass), cardiogenic shock, acute pulmonary edema (APE), mortality. TnI relevant values group (80.26 %) correlates much better with all six events compared with group TnI <0.05 pg / mL. In addition, the subgroup with TnI more than 10 ng / mL developed acute pulmonary edema and / or cardiogenic shock in 90.67 % with PCI and CABG growth and high mortality. In this STEMI population, TnI improves diagnostic accuracy and the management of complications. “Troponin blindness” rate of 19.74 % can be explained either by the quality of the biomarker, either by the late presentation of the majority of the patients.
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