Troponin Levels Predict Left Ventricular Function Post ST Elevation Myocardial Infarction

Aim: Prognosis following acute ST elevation myocardial infarction (STEMI) largely relates to the extent of irreversibly damaged myocardium. Imaging techniques are routinely used in clinical practice to estimate infarct size and left ventricular ejection fraction (LVEF). Serum troponin T (TnT), a myocardial contractile protein, is a sensitive biochemical marker for diagnosis of STEMI but there have been limited reports on its ability to predict LVEF. We hypothesise that higher TnT values predict poor LVEF. To determine the utility of serum TnT as a marker to predict impaired LVEF as assessed by echocardiography in patients with first STEMI. Method: A total of 73 patients with first episode of STEMI were identified retrospectively from the Waikato Hospital STEMI database of 2015. Peak TnT levels and LVEF were recorded from the hospital electronic records. LVEF was assessed by Simpson's Biplane method. TnT level was compared to echocardiography LVEF. Results: TnT was found to have a strong negative correlation with LVEF as deduced by the Pearson's correlation coefficient value of -0.504 (p < 0.001) i.e. with increasing levels of TnT there was a decline in LVEF. TnT values >1966 predicted LVEF < 40% (p = 0.028). Conclusion: Peak TnT levels are a simple, inexpensive and non-invasive method to identify patients with impaired LV function of <40% who are at higher risk for adverse cardiovascular outcomes.