Procalcitonin and Troponin-I as Predictor of Mortality in Acute Myocardial Infarction Patients

Authors

DOI:

https://doi.org/10.24293/ijcpml.v28i2.1817

Keywords:

Procalcitonin, troponin-I, acute myocardial infarction, mortality

Abstract

Acute Myocardial Infarction (AMI) is known as one of the leading causes of death in the world as well as in Indonesia. Procalcitonin is a marker of inflammation that has been recognized as a predictor of mortality in sepsis patients. The role of procalcitonin as a predictor of mortality in AMI patients has not been widely studied. Troponin-I has been recognized as a biomarker of AMI. It is unclear whether Troponin-I can also act as a biomarker to predict the death of AMI patients. This study aim is to determine the role of procalcitonin and troponin-I as predictors of mortality in AMI patients. A 5-month analytical observational study was performed on AMI patients who were admitted to Dr. Saiful Anwar, Malang. Patients with sepsis or infection were excluded. There were 51 study subjects, of whom median procalcitonin and troponin-I levels of patients who died were significantly different from survivors (p<0.05). Procalcitonin level with a cut-off of 2.16 ng/mL had a sensitivity of 77% and specificity of 87%. Troponin-I level with a cut-off of 3.1 ng/mL had a sensitivity of 61% and specificity of 84%. Odds ratio of procalcitonin to mortality was 17.78 (p=0.001), while troponin-I was not significant. Procalcitonin correlated with mortality (r= 0.519, p= 0.005). The conclusion of this research is procalcitonin acts as a predictor of in AMI patients.

Downloads

Download data is not yet available.

Author Biographies

Novi Khila Firani, Brawijaya University

Clinical Pathology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia; Biochemistry and Biomolecular Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia

Jennifer Prisilla, Brawijaya University

Resident of Clinical Pathology, Faculty of Medicine, Brawijaya University, Malang, Indonesia

References

Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations. Int J Cardiol, 2013;168(2): 934–45.

Akwe J, Halford B, Kim E, Miller A. A review of cardiac and non-cardiac causes of troponin elevation and clinical relevance part I: Cardiac causes. J Cardiol Curr Res, 2017;10(3): 1–8.

World Health Organization. Cardiovascular diseases (CVDs) [Internet]. 2017 [cited 2020 Jun 8]. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

World Health Organization. Global status report on noncommunicable diseases 2014 [Internet]. 2014. Available from: https://www.who.int/nmh/publications/ncd-status-report-2014/en/

Ministry of Health Republic of Indonesia. Riset kesehatan dasar (National Health Survey). 2018.

Ong S, Hernández-reséndiz S, Crespo-avilan GE, Mukhametshina RT, Kwek X, Cabrera-fuentes HA, et al. Pharmacology & Therapeutics Inflammation following acute myocardial infarction: Multiple players, dynamic roles, and novel therapeutic opportunities. Pharmacol Ther, 2018;186: 73–87.

Christ-Crain M, Müller B. Procalcitonin and pneumonia: Is it a useful marker?. Curr Infect Dis Rep, 2007; 9: 233–40.

Samsu N, Sargowo D. Sensitivitas dan spesifisitas Troponin T dan I pada diagnosis infark miokard akut. Maj Kedokt Indones, 2007; 57: 363–72.

Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Pedoman tatalaksana sindrom koroner akut. J Kardiol Indones, 2015; 3: 4–29.

Napolitano LM. Definitions and Guideline Changes. Surg Infect (Larchmt). 2018;19(2):117–25.

Dong R, Wan B, Lin S, Wang M, Huang J, Wu Y, et al. Review article procalcitonin and liver disease: A literature review. J Clin Transl Hepatol, 2019; 7: 51–5.

Kafkas N, Venetsanou K, Patsilinakos S, Voudris V, Antonatos D, Kelesidis K, et al. Procalcitonin in acute myocardial infarction. Acute Card Care, 2008;10:30–6.

Vijayan AL, Ravindran S, Saikant R, Lakshmi S, Kartik R, Manoj G. Procalcitonin: A promising diagnostic marker for sepsis and antibiotic therapy. J Intensive Care, 2017;5(51):1–7.

Akwe J, Halford B, Kim E, Miller A. A review of cardiac and non-cardiac causes of Troponin elevation and clinical relevance part II: Non-cardiac causes. J Cardiol Curr Res, 2018;11(1):9–16.

Dai J, Xia B, Wu X. Elevated plasma procalcitonin level predicts poor prognosis of ST elevation myocardial infarction in Asian elderly. Scand J Clin Lab Invest, 2017;1–6.

Hristov M, Weber C. Lost in the Biomarker Labyrinth. Circ Res, 2015;116:781–3.

Ertem AG, Efe TH, Akboga MK, Acar B, Unal S, Kırbas O, et al. The association between serum procalcitonin levels and severity of coronary artery disease assessed by SYNTAX score in patients with acute coronary syndrome. Angiology, 2016;68:40–5.

Daubert MA, Jeremias A. The utility of troponin measurement to detect myocardial infarction: Review of the current findings. Vasc Health Risk Manag, 2010;6:691–9.

Antman EM, Tanasijevic MJ, Bruce T, Schactman M, H. McCabe CH, et al. Cardiac-specific Troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med,1996; 335:1342–9.

DeFillipi CR, de Lemos J A, Christenson RH, Gottdiener JS, Kop WJ, Zhan M. Association of serial measures of cardiac Troponin T using a sensitive assay with incident heart failure and cardiovascular mortality in older adults. JAMA, 2010; 304(22): 2494–502.

Downloads

Submitted

2020-12-22

Accepted

2021-03-17

Published

2022-06-03

How to Cite

[1]
Firani, N.K. and Prisilla, J. 2022. Procalcitonin and Troponin-I as Predictor of Mortality in Acute Myocardial Infarction Patients. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 28, 2 (Jun. 2022), 170–174. DOI:https://doi.org/10.24293/ijcpml.v28i2.1817.

Issue

Section

Articles