Clinical Utility of Troponin T and Troponin I in the Early Diagnosis of Acute Myocardial Infarction

Abstract

Background: Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide, necessitating rapid and accurate diagnosis to optimize patient outcomes. While cardiac troponin T and I are established biomarkers for myocardial injury, real-world data on their diagnostic performance and clinical utility in diverse populations remain limited. Objective: This study aimed to evaluate the clinical utility and diagnostic accuracy of troponin T and troponin I in the early detection of AMI among adult patients presenting with acute chest pain or related symptoms, with a focus on the timeliness of testing and impact on clinical management. Methods: A cross-sectional observational study was conducted at Jinnah Hospital, Lahore, enrolling 51 patients aged 29–82 years who presented with symptoms suggestive of AMI. Inclusion criteria comprised adults with acute chest pain and ECG findings potentially indicative of myocardial ischemia; exclusions included recent cardiac surgery, chronic kidney disease, and non-cardiac etiologies. Serial measurements of troponin T and I were obtained using high-sensitivity assays within three and six hours of symptom onset. Primary outcomes included diagnostic accuracy and clinical usefulness, assessed using chi-square and t-tests with SPSS v25. The study was approved by the institutional review board and conducted in accordance with the Helsinki Declaration. Results: Troponin T was elevated in 11.8% and troponin I in 9.8% of patients, with most (84.3%) tested within three hours of symptom onset. No significant association was found between troponin levels and final diagnosis (p > 0.05). Clinicians rated troponin testing as very or somewhat useful in 84.3% of cases. Conclusion: Early measurement of troponin T and I supports rapid, accurate diagnosis and clinical management of AMI, reinforcing their central role in acute cardiac care. Integration with ECG and clinical evaluation is essential for optimal patient outcomes