Predictive Value of High-Sensitivity Cardiac Troponin and Other Biomarkers in Patients with Suspected Acute Coronary Syndrome
Abstract
Introduction: Acute coronary syndrome (ACS) represents a spectrum of clinical conditions associated with acute myocardial ischemia and infarction, encompassing unstable angina, nonST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). Objectives: The main objective of the study is to find the predictive value of highsensitivity cardiac troponin and other biomarkers in patients with suspected acute coronary syndrome. Methodology of the study: This prospective cohort study was conducted at Insaf Medical Complex, Karachi during June 2023 to March 2024. A total of 865 patients presenting with symptoms suggestive of ACS were enrolled in the study. Results: Data were collected from 865 patients. Mean age of 58.76±2.35 years. The cohort consisted of 58% males and 42% females. Among the participants, 65% had hypertension, 35% had diabetes mellitus, and 30% had a history of smoking. The diagnostic performance of the biomarkers was evaluated, revealing high-sensitivity cardiac troponin (hs-cTn) with a sensitivity of 95%, specificity of 85%, PPV of 88%, NPV of 94%, and an AUC of 0.93. BNP showed a sensitivity of 70%, specificity of 80%, PPV of 75%, NPV of 76%, and an AUC of 0.75. NT-proBNP had similar metrics with a sensitivity of 72%, specificity of 78%, PPV of 74%, NPV of 76%, and an AUC of 0.74. Conclusion: The integration of hs-cTn with other biomarkers enhances diagnostic accuracy and risk stratification, enabling more personalized and effective patient care. By leveraging the predictive value of these biomarkers, clinicians can improve the early detection, intervention, and outcomes for patients with suspected ACS.
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