CORRELATION OF SEVERITY OF ELECTROCARDIOGRAPHIC CHANGES AND TROPONIN LEVEL IN ACUTE CORONARY SYNDROME.docVIP

CORRELATION OF SEVERITY OF ELECTROCARDIOGRAPHIC CHANGES AND TROPONIN LEVEL IN ACUTE CORONARY SYNDROME Snezana Ciric-Zdravkovic The level of troponins and change in electrocardiograms are two corner stones for the diagnosis of acute coronary syndrome (ACS). The aim of the study was to investigate the correlations between electrocardiographic (ECG) changes and troponin status in ACS. The examined population involved 333 patients admitted to the Coronary Care Unit with the admittance diagnosis of ACS. Of exceptional interest was the myocardial infarction without ST elevation (NSTEMI) which included 50% of patients. The changes in electrocardiogram: existence and depth of ST-segment depression on admittance during the treatment and discharge; changes on T wave and forming of new Q wave. Advantage is early appearance of electrocardiographic changes before troponins elevation. Troponins (T and I) were examined for positive and negative results and top of concentration. This method’s advantages are sensitivity and specificity. Results: ST-segment depression of 1 and 2 mm was found in 21% of patients; 3-4 mm in 10% and ≥5 mm in 2.63% of patients. Troponin was positive in 40% of patients. In 65 (34%) patients, there was no electrocardiographic change except for positive troponin. Conclusion: High sensitivity and specificity of troponins were proved in ACS diagnosing and there was good correlation with depth of ST-segment depression. This is of special interest in making NSTEMI diagnosis and risk stratification. Troponin level in combination with depth of ST-segment depression identifies much more serious coronary arterial disease and much more effective early invasive strategy. Acta Medica Medianae 2007;46(2):9-15. Key words: acute coronary syndrome, ECG changes, troponins (T and I), NSTEMI Clinic of cardiovascular disseases Clinical Center in Nis while the ST depression segment qualitative impo- rtance on ACS pa