Comparison of Troponin I and Cardiac Enzymes as Diagnostic Markers for Acute Myocardial Infarction (AMI) in Cardiac Patients from a Tertiary Care Hospital of Lahore-Pakistan

Abstract

Background Acute Myocardial Infarction (AMI) is a serious medical condition in which sudden damage occurs to heart muscles due to blockage of blood supply in coronary arteries. The clinical investigation of AMI is based on the evaluation of specific heart markers i.e. Troponin I and cardiac enzymes with variable efficacy and specificity.

Materials and Methods: A cross-sectional study was conducted on 130 subjects, including 100 patients suffering with Acute Myocardial Infarction (AMI) and 30 healthy subjects. The whole research work samples were collected during Februray 2022 to March 2022 and completed in Accident and Emergency Diagnostic Laboratory, Mayo Hospital Lahore. The Troponin I serum levels were determined by using Chemiluminescence Access2 reagents kit (Beckman Coulter, USA) on chemistry analyzer. Whereas, cardiac enzymes i.e. serum CPK, CK2 (CK-MB) and LDH were determined by using chemical reagents manufactured by (Beckman Coulter, USA) spectrophotometrically on fully automated chemistry analyzer AU-480.

Results: The study was conducted on 77% of positive group patients (n=100) diagnosed with AMI, moreover, 23% healthy individuals (n=30) were taken as control group. In control group the mean value of serum Troponin I and cardiac enzymes including CK-MB, CPK and LDH were 0.0160±0.001 ng/mL, 13.70±1.030 U/L, 105.87±4.454 U/L and 141.70±2.396 U/L respectively, whereas for positive group these values were 2.3957±0.783 ng/mL, 48.56±4.997 U/L, 327.42±53.68 U/L and 575.09±38.008 U/L respectively. In control group serum Troponin-I showed negative correlation with CK-MB, CPK and LDH by applying Pearson Correlation i.e. (p>0.05) respectively. Whereas, in positive subjects serum Troponin I showed positive correlation with CPK and CK-MB (p<0.05) while negative correlation with LDH.

Conclusion: The present study demonstrated that serum cardiac Troponin I and cardiac enzymes i.e. serum CK-MB and CPK prove to be superior cardiac biomarker as compared serum LDH for the evaluation of Acute Myocardial Infarction in the effected population.