Molugu Sai Venkatram Reddy, Molugu Chaitra Reddy, Chalasani Venkata Bhargava, Badvel Srinivasa Reddy
Medicine, Osmania Medical College, Hyderabad, IND.
Medicine, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, IND.
Cureus. 2025 Sep 11;17(9):e92063. doi: 10.7759/cureus.92063. eCollection 2025 Sep.
This study aimed to estimate the cardiac troponin-T (cTnT) levels in patients with acute myocardial infarction (AMI) to measure the short-term prognosis.
Sixty patients with symptoms of AMI within six hours of onset were included, and the prognostic significance of cTnT levels was evaluated to predict mortality, recurrent ischemic events, and heart failure. The diagnostic performance of cTnT was evaluated through sensitivity and specificity analysis based on the determined cut-off value. All participants underwent clinical evaluations, echocardiograms, and received thrombolytic therapy.
Among study participants, 45 patients were male (75%) and 15 were female (25%), and the mean age was 50.7±7.93 years. Cardiac troponin T was positive (cTnT >0.18 ng/mL) in 50 (83.34%) cases and negative in 10 (16.66%) cases. The mean cTnT levels were higher in patients who did not survive than those who did (2.92±1.43 vs 0.705±0.63 ng/mL). A cTnT levels between patients with and without recurrent angina shows a significant difference (1.9705±1.538 vs 0.82±0.915 ng/mL, p<0.001). A cTnT level of 0.22 ng/mL at presentation diagnosed AMI with a sensitivity of 76.92% and a negative predictive value (NPV) of 98.2%, and a specificity and positive predictive value (PPV) of 100% and 65.4%, respectively. A cut-off cTnT value of 2.2 ng/mL predicted mortality with a sensitivity of 76.92% and a negative predictive value (NPV) of 94%, and a specificity and positive predictive value (PPV) of 100% each. The multivariable analysis revealed several factors significantly associated with mortality: point-of-care cardiac troponin T ≥0.22 ng/mL (hazard ratio (HR): 1.95, 95% confidence interval (CI): 1.85-2.19), heart failure (HR: 1.85, 95% CI: 1.65-2.08), recurrent angina (HR: 1.38, 95% CI: 1.19-1.55), and reinfarction (HR: 1.04, 95% CI: 0.99-1.12).
Cardiac troponin T positivity at admission consistently correlated with decreased rates of reperfusion after thrombolysis and lower ejection fraction. Cardiac troponin-T levels at admission can be able to predict the short-term prognosis, mortality, recurrent ischemic events, and heart failure in patients with AMI.
本研究旨在评估急性心肌梗死（AMI）患者的心肌肌钙蛋白T（cTnT）水平，以衡量短期预后。
纳入60例发病6小时内出现AMI症状的患者，评估cTnT水平对预测死亡率、复发性缺血事件和心力衰竭的预后意义。基于确定的临界值，通过敏感性和特异性分析评估cTnT的诊断性能。所有参与者均接受临床评估、超声心动图检查，并接受溶栓治疗。
研究参与者中，男性45例（75%），女性15例（25%），平均年龄为50.7±7.93岁。50例（83.34%）患者心肌肌钙蛋白T呈阳性（cTnT>0.18 ng/mL），10例（16.66%）呈阴性。未存活患者的平均cTnT水平高于存活患者（2.92±1.43 vs 0.705±0.63 ng/mL）。有复发性心绞痛和无复发性心绞痛患者的cTnT水平存在显著差异（1.9705±1.538 vs 0.82±0.915 ng/mL，p<0.001）。就诊时cTnT水平为0.22 ng/mL诊断AMI的敏感性为76.92%，阴性预测值（NPV）为98.2%，特异性和阳性预测值（PPV）分别为100%和65.4%。cTnT临界值为2.2 ng/mL预测死亡率的敏感性为76.92%，阴性预测值（NPV）为94%，特异性和阳性预测值（PPV）均为100%。多变量分析显示，有几个因素与死亡率显著相关：即时检测心肌肌钙蛋白T≥0.22 ng/mL（风险比（HR）：1.95，95%置信区间（CI）：1.85 - 2.19）、心力衰竭（HR：1.85，95%CI：1.65 - 2.08）、复发性心绞痛（HR：1.38，95%CI：1.19 - 1.55）和再梗死（HR：1.04，95%CI：0.99 - 1.12）。
入院时心肌肌钙蛋白T阳性与溶栓后再灌注率降低和射血分数降低始终相关。入院时心肌肌钙蛋白T水平能够预测AMI患者的短期预后、死亡率、复发性缺血事件和心力衰竭。
