The relation between ECG changes and troponin test in patients with non ST segment elevation acute coronary syndrome


ABSTRACTObjectives: This article focuses on unstable angina and non ST segment elevation myocardial infarction. The objectives are to clarify different ECG pattern, to correlate it with troponin results, and to evaluate the effects of risk factors. Methods: Seventy patients with clinical diagnosis of acute coronary syndrome were collected from coronary care unit in Ibn Sina Teaching Hospital in Mosul, 20 patients with ST segment elevation were excluded, and ECG changes were evaluated. Forty five patients had troponin I test, and the results were compared to their ECG changes. The risk factors and their numbers were studied. Data statistically analyzed using Z- 2 proportion and Chi-square tests. Results: Fifty patients with a mean age 57 year (SD 13.2), including 26 males and 24 females, show (in order of frequency): ST depression (44%), non-specific ECG (24%), T wave inversion (22%), and BBB (10%). Fifteen (33%) had positive troponin test, most of them were males (80%), showed significant association with T wave inversion (p value= 0.05). Specific ECG changes were associated with male gender, diabetes mellitus, hypertension, and old age (p value<0.03). Troponin positivity was associated with male sex (p value=0.003). Male gender and smoking were associated with positive troponin in significant ECG group (p value<0.04). All patients with positive troponin had at least two risk factors (p value=0.002).Conclusion: ST segment depression was the most common ECG changes in non ST elevation acute coronary syndrome, but T wave inversion was more significantly associated with troponin positivity, which differs from previous studies. Male gender was the most critical risk factor; this was consistent with previous studies. Number of risk factor has important effect on ECG and troponin results.


ECG, troponin, ACS