Typical rise and fall pattern of cardiac Troponin I in diagnosing non-St elevation acute coronary syndrome in patients admitted with chest pain

Objective: To monitor the rise and/or fall pattern of cardiac troponin l in diagnosing non-St elevation acute coronary syndrome in patients admitted with chest pain. Material and Methods: This descriptive study was conducted at combined military hospital from May 31st 2022, to November 2nd, 2022.Patients with typical chest pain with no change or ST elevation in their ECG were monitored through cardiac troponin I (cTnI) levels at three levels of interval at 6 hours, 12 hours, and before discharge. Result: 271 patients were included. The average age of the patients was 54.59 ± 13.60 years. Out of the 271 patients included in the study, 69 patients (25.46%) exhibited an upward trend in cardiac troponin I (cTnI) levels over time, a falling pattern of cTnI was noted in 58 patients (21.4%) patients; and a rise and/or fall pattern of cTnI was reported in 135 patients (49.82%). These patients were treated accordingly as per the guidelines of the American Heart Association for myocardial infarction. Conclusion: The rise and/or fall pattern of cardiac troponin I has shown significant promise in diagnosing NSTEMI ACS patients. The dynamic changes in cardiac troponin levels over time provide valuable information regarding myocardial injury and help differentiate between myocardial infarction and other causes of chest pain. The rise and/or fall of cardiac troponin I exhibits a characteristic pattern that aligns well with the pathophysiology of NSTEMIACS, allowing for a more accurate and timely diagnosis. Additionally, the serial monitoring of cardiac troponin I levels can aid in risk stratification for patients, guide treatment decisions, and improve clinical outcomes. Keywords: Chest pain, Myocardial infarction, Troponin I, NTSEMI