Association of Troponin-I Level with Left Ventricular Systolic Dysfunction after First Episode of Non- ST Elevation Myocardial Infarction

Md Shariful Islam, Abdul Kader Akanda, Mohammad Ullah, Md Gulam Mostafa, Md Zillur Rahman, Mohammad Mamoon Islam

Background: Serum troponin is an exquisitely sensitive marker of myocardial injury and is necessary
for establishing the diagnosis of Myocardial Infarction particularly non-ST elevation myocardial infarction
(NSTEMI). However, the relation of troponin-I level with left ventricular systolic dysfunction following
first episode of NSTEMI are still not examined in our population. Therefore, to determine the relationship
of serum troponin I with left ventricular ejection fraction after first episode of NSTEMI was set as an
objective of the study.
Methods: This cross sectional analytical study was conducted on 160 patients. They were divided into
the two groups (80 patients in each group): Group-A (Troponin I level e” 0.4 ng/ml) high risk group and
Group-B (Troponin I level < 0.4 ng/ml) low risk group. Left ventricular systolic dysfunction was defined
as ejection fraction (EF%) < 50% calculated by modified Simpson’s method on transthoracic
echocardiography. Association of troponin-I level with left ventricular systolic function was determined.
Results: Among a total 160 patients, no significant variation across the group A and B in terms of age,
gender and occupation (p>0.05 in all cases). Median serum troponin I of group A was 7.24 (range: 0.41-
58.25) and group B was 0.21(range: 0.12-0.39). Left ventricular EF was significantly lower in higher
troponin I group (Group A-45.95±10.28 vs. Group B-56.30±7.78; p<0.05) and it was associated with
higher proportion of left ventricular dysfunction (p<0.05).
Conclusion: Serum troponin-I can be considered as a predictor of the left ventricular systolic dysfunction
in first episode of Non-ST elevation myocardial infarction patients.