Evaluation of the diagnostic value and differentiation efficacy of high sensitivity cardiac troponin T2 (hscTnT2) for STEMI and NSTEMI Iraqi patients with acute coronary syndrome

Abstract

Introduction and Aim: Two major clinical forms of acute coronary syndrome (ACS) were categorized; acute myocardial infarction (MI) showing ST-segment elevation (STEMI) with ECG, the other non-ST-segment elevation (NSTEMI). This study was designed using a new generation of high sensitivity cardiac troponin T2 (hscTnT2) in patients with acute coronary syndrome to evaluate the diagnostic value and its efficacy in differentiation of STEMI from NSTEMI.   Materials and Methods: one hundred twenty (120) patients diagnosed to have ACS were included in the study. Apparently, sixty-four (64) healthy subjects were considered as control.  ECG and body mass index (BMI) were performed. Blood analysis of levels of glucose, lipid profile and glutamic-oxaloacetic transaminase (GOT) were measured as well as estimated the human hscTnT2 concentrations by enzyme linked immunosorbent assay (ELISA).   Results:  ACS patients (STEMI & NSTEMI) showed significant high levels (hscTnT2), Cholesterol, TG, HDL, GOT, FBS and VLDL compared to control. Furthermore, (hscTnT2) serum level in STEMI 225.95 ±120.66 ng/L is significantly higher (P value <0.001) than NSEMI 102.32 ± 58.542 ng/L. the discrimination efficacy of hscTnT2 to differentiating STEMI from NSTEMI is high with cut off value 90.3 ng/L with high sensitivity.   Conclusion: The use of new generations of high sensitivity troponin T aided to reduce the time for accurate diagnosis of acute MI to less than 2 hours. The hscTnT serum value was higher in STEMI than NSTEMI patients and shown to be positively correlated with the degree of cardiac damage in ACS patients. The level of hscTnT can be considered as good discriminating diagnostic biomarkers to differentiate STEMI from NSTEMI patients.