Association of Troponin-I Level on Admission with 6-month Clinical Consequences in Acute Coronary Syndrome Patients: A Preventive Approach in Patient Care

Background: Cardiovascular diseases are the leading cause of mortality worldwide. Therefore, it is important to predict the future consequences of the disease in patients who have recovered. Objectives: We sought to determine the relationship between troponin-I level and 6-month clinical consequences (i.e., re-infarction, death, re-angiography and coronary artery bypass grafting) in patients with acute coronary syndrome (ACS). Methods: This prospective cross-sectional study was performed among 60 patients with ACS admitted to Ayatollah Mousavi Hospital in Zanjan, Iran. The participants were chosen using the convenience sampling method. Troponin-I level in these patients was initially evaluated.  Afterwards, they were followed up for six months in terms of clinical consequences. A checklist was prepared to collect the required data. The receiver operating characteristic (ROC) analysis was conducted to determine the predictive power of high-sensitivity troponin I for the mentioned consequences. Iodine index was calculated to determine the cutoff point for this enzyme in order to predict the consequences. Results: In general, 66.2% of the participants were male and the mean age was 60.46 ± 12.78 years. We found that 21.2% of the participants experienced one of the four clinical consequences in the follow-up period of 6 months. The sub-curved surface was calculated to be 0.705 for the prediction of consequences. The cutoff point for the prediction of consequences was 32.5; the negative predictive value for the cutoff point was 32.5, which was equal to 89.8%. Conclusion: Troponin-I has an acceptable predictive power to identify 6-month consequences of ACS. Moreover, considering the negative predictive value of troponin-I, it is recommended to use this biomarker in patients with ACS. In addition, healthcare providers should pay more attention to the follow-up of patients after discharge and design preventive programs.