Besides diagnostic and prognostic value, troponins, as sensitive and specific markers of myocardial necrosis, have a very important role in selecting acute coronary syndrome (ACS) patients for coronarography and decide on appropriate therapy (conservative or invasive). Several angiographic and angioscopic studies have demonstrated that the presence and magnitude of intracoronary thrombus is directly related to the concentration of cardiac troponin (cTn). The study enrolled 333 [unstable angina and non-ST-elevation myocardial infarction (NSTEMI)] patients treated in the Cardiovascular Clinic University (CCU) Clinical Center in Nis, Serbia. Laboratory analysis involved troponin Τ and I (TnT, Tnl), myoglobin, creatine kinase-MB (CK-MB) and CK-MB mass. Invasive examinations and invasive therapeutic procedures were done at the end of hospitalization (coronarography, percutaneous coronary intervention (PCI), aorto-coronary bypass grafting (ACBG). Out of 104 coronarographies in a group with one and two diseased coronary vessels, 46.4% were Tn positive, compared with 29% Tn-negative patients, which was also seen in a group with >3 diseased coronary vessels (3.2% ν 14.8%). Patients with a higher level of troponin elevation had a greater number of affected coronary arteries and lesions that were more complicated. Out of 104 coronarographied patients, 29 (8.1%) underwent PCI and 25 (7%) ACBG. Statistical significance occurred in choosing patients for PCI according to Tn status (p < .05), but not in the group selected for ACBG. In our investigation, cTn levels were reliable factors for the degree and severity of coronarographic findings, as well as a guideline in choosing invasive treatment strategy.
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