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STUDY OF CARDIAC TROPONIN-I AS A DIAGNOSTIC MARKER IN COMPARISION WITH CREATINE KINASE-MB IN MYOCARDIAL INFARCTION

BACKGROUND: Myocardial infarction is a medical emergency that most often caused by an exclusive coronary thrombus which results in prolonged myocardial ischemia and irreversible cell death. Early diagnosis of myocardial infarction is crucial in planning the treatment modalities, which if instituted in time reduces the morbidity and mortality considerably. OBJECTIVES: To evaluate the usefulness of cardiac troponin-I in the early diagnosis of myocardial infarction and in assesing the severity of the infraction. The study also compares cardiac troponin-I with cardiac marker creatine Kinase-MB. METHODS: The present study comprises of 100 subjects which includes 50 healthy controls and 50 subjects with myocardial infarction, in whom the following parameters were analysed on admission and after 24hours. The parameters are cardiac troponinI (Chemiluminesence immunoassay method), creatinekinase –MB (optimized DGKC method by semi auto ananlyzer). RESULTS: Cardiac troponin –I is better than creatine kinase –MB in diagnosing myocardial infarction .On admission the increase in serum cardiac troponin –I is highly significant in subjects with MI (p<0.001)when comparied to creatine kinase-MB .In our study the cutoff value of cardiac troponin –I is 0.60ng/ml by taking the mean of healthy controls .cardiac troponin-I level greater than 0.60ng/nl is used as positive value .The sensitivity and specificity of troponin-I is 96% and 98% respectively which is higher than creatine kinase-MB(62%and 68%)respectively ,within the first 6 hours of myocardial infarction .The diagnostic efficiency of cardiac troponin-I is 97%,and creatine kinase –MB is 63% in diagonosis of acute MI. CONCLUSION: Serum cardiac troponin-I is highly sensitive and specific cardiac marker which can substantially improve the early diagnosis of acute mycocardial infartion so that adequate treatment modalities can be initiated early in these patients to minimise the risk of death.The estimation of serum cardiac troponin-I level can be routinely employed to confirm or rule out acute myocardial infarction as a part of laboratory evaluation of acute myocardial infarction .