International Journal of Multidisciplinary Health Sciences and Research

Category: Original Article,      DOI: Recived: 23/10/2023, Accepted: 22/12/2023, Published online: 29/12/2023

Comparative Analysis of High-Sensitivity Troponin Assays for Risk Stratification in Non-ST Elevation Myocardial Infarction

Abha Pandey1*, Shweta Dwivedi2

Abstract: Background: High-sensitivity cardiac troponin (hs-cTn) assays have improved the diagnosis and risk stratification of non-ST elevation myocardial infarction (NSTEMI). This study aimed to compare the diagnostic and prognostic performance of hs-cTnI and hs-cTnT assays for risk stratification in NSTEMI patients. Methods: In this prospective, observational cohort study, 550 patients with NSTEMI were enrolled. hscTnI and hs-cTnT were measured at presentation and serially. The primary outcome was major adverse cardiovascular events (MACE) at 30 days and 12 months. Diagnostic accuracy, prognostic value, and incremental value over the GRACE score were assessed. Results: Both assays showed excellent diagnostic performance for 30-day MACE (AUC: hs-cTnI 0.86, hs-cTnT 0.84; p=0.09). For 12-month MACE, adjusted hazard ratios were 2.8 (95% CI: 2.1-3.7) for hscTnI and 2.6 (95% CI: 2.0-3.4) for hs-cTnT. Adding hs-cTn to the GRACE score improved risk stratification (NRI: hs-cTnI 0.38, hs-cTnT 0.35). Both assays demonstrated high negative predictive values (>99%) in early rule-out strategies. Conclusions: hs-cTnI and hs-cTnT show comparable and excellent performance in risk stratification of NSTEMI patients. Both assays provide significant incremental value over the GRACE score and perform well in early rule-out strategies, supporting their use in clinical practice for improved patient management.