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INVESTIGATION OF HIGH-SENSITIVITY TROPONIN I LEVELS AND THEIR CORRELATION WITH CLINICAL AND PARACLINICAL FACTORS IN PATIENTS WITH ARRHYTHMIAS
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Abstract
Background: Elevated high-sensitivity cardiac troponin I (hs-cTnI) is frequently observed in patients with cardiac arrhythmias, complicating the diagnosis of underlying coronary artery disease (CAD). This study investigated the characteristics of hs-cTnI, its correlation with clinical factors, and its diagnostic utility for CAD in arrhythmia patients. Methods: A cross-sectional study was conducted on 244 patients admitted with arrhythmias (atrial fibrillation, ventricular tachycardia, and bradyarrhythmias) at a tertiary referral center. We analyzed correlations between hs-cTnI and hemodynamic/biochemical markers. Receiver Operating Characteristic (ROC) analysis was performed to determine the optimal cut-off value for predicting CAD. Results: Elevated hs-cTnI (>99th percentile) was present in 42.2% of the cohort, with the highest prevalence in the atrial fibrillation group. hs-cTnI exhibited a strong positive correlation with NT-proBNP (r = 0.612, p < 0.001) but no significant correlation with heart rate. Multivariate regression identified NT-proBNP and the presence of CAD as independent predictors of elevated hs-cTnI. Patients with CAD had significantly higher median hs-cTnI levels compared to those without (116.6 vs. 9.3 pg/mL, p < 0.001). An optimal cut-off of ≥ 36 pg/mL yielded an Area Under the Curve (AUC) of 0.84, offering 82% sensitivity and 76% specificity for CAD prediction. Conclusion: In arrhythmia patients, hs-cTnI elevation reflects both hemodynamic stress and potential ischemia. An optimized cut-off of 36 pg/mL improves diagnostic accuracy for CAD compared to the standard reference limit, helping to reduce false-positive rates.
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Keywords
High-sensitivity Troponin I, Arrhythmia, Coronary Artery Disease, NT-proBNP, Diagnostic value.
References
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