Cardiac TroponinIand the Stratification of Acute Coronary Syndrome Patients

Objective:The purpose of this study is to investigate the clinical signification of relationship between serum quantitative analysis troponin Ⅰ(cTnI) and the stratification of acute coronary syndrome(ACS)patients.Methods:Blood samples were obtained at admission,12,24 hours later from 103 patients with ACS.Serum concentrations of cTnI and CK-MB were simultaneously measured using the solid-phase two-site chemiluminescent immunometric assay by IMMULITE systems.According to CK-MB and ECG,We divided all the patient into three subgroups,unstable angina(UA)?Q wave myocardiac infarction (QMI)?and none Q wave myocardiac infarction (NQMI),So we could analyse the relations between the changes of cTnI and clinical conditions,the characteristics of coronary lesion and the cardiac events,including AMI,sudden death and refractory angina pectoris.Results:The serum cTnI value was 0.20±0.08ng/ml,32.84±23.23ng/ml,9.49±5.82ng/ml and l.16 ±0.77ng/ml in the health control,QMIgroup NQMIgroup and UA group defined at (P0.05) respectively.When the cutoff of cTnI and CK-MB were 2.0 ng/ml and8.0ng/ml,The sensitivity and specificity were inferior to cTnI in diagnosing AMI.In the UA group(n=60) which CK-MB was not high enough,there was 27 patients with cTnI ≥0.4ng/ml,while in the NQMI group(n=13) there was 11 patients with high cTnI.Among all 103 patients with ACS,4 died within 30days,which were all in cTnI ≥0.4ng/ml group.With the progressive increase of cTnI,the cardiac events also increase;which would be related to the quantity of myocardiac necrosis.So cTnI had higher negative predictive values.Conclusion:Quantitative measurement of serum cTnI would the good marker to the stratifiction of patients with ACS and would be of improtant prognostic values.