Comparison of coronary angiography results based on troponin-I and high-sensitivity troponin-I elevations in patients presenting to the emergency department with non-ST elevation myocardial infarction. Gaziantep University Faculty of Medicine, department of emergency medi̇ci̇ne, medical specialty thesis

This study aimed to compare the effects of hs-cTn and Standard Troponin-I measurements on the diagnosis of NSTEMI and the management of myocardial injury in the emergency department. The objective was to evaluate the role of different troponin assays on coronary angiography decisions and the need for further investigations. In this retrospective cohort study, patients diagnosed with NSTEMI who underwent coronary angiography were assessed, comparing the results of Standard Troponin-I and hs-Troponin-I measurements. Patients aged over 18, with NSTEMI (excluding STEMI), and who underwent coronary angiography were included; demographic data, chronic comorbidities, laboratory results, and angiographic findings were evaluated. Statistical analyses were performed using SPSS 22.0, and a p-value <0.05 was considered statistically significant. A total of 396 patients from 2018 and 2021 were included; significant coronary artery disease (CAD) was detected in 66.7% of the Standard Troponin-I group and 70.1% of the hs-Troponin-I group (p=0.045). The mean age ranged from 63 to 67 years, and males predominated in both groups (62.5–68.3% ). A positive correlation was found between troponin levels and Gensini scores (r=0.258, p=0.001), and 57.8% of the patients underwent stent placement. This study demonstrated that hs-cTn tests are more sensitive than Standard Troponin-I for NSTEMI diagnosis and superior in predicting anatomically significant coronary artery disease. The findings indicate that hs-cTn is a key tool in modern acute coronary syndrome management, both for early detection of myocardial injury and for supporting invasive management decisions.