Correlation of troponin rapid test and severity of coronary artery disease in patients with chest pain

Background: many patients in emergency are admitted with chest pain,whether typical or atypical. they undergo varieties of tests to diagnose whether they are suffering from ischemic heart disease or not. one of the tests performed in the emergency is troponin t rapid test. study design: this is an observational study of 100 patients who presented with chest pain from january 2013 to june 2013. they were all admitted in the hospital. 50% of the patients were troponin t rapid test positive and 50% of them were negative. all of them underwent coronary angiogram. a coronary angiography severity criterion was defined as significant coronary artery disease with more than 50% diameter stenosis in vessels more than 1.5mm diameter. result: the average age of patients in the study is 55 years. the average age of troponin positive patient is 56+/-14 years with male average age of 55 years and female average age of 58 years. the male average age in this group was slightly lower than female. the average age in troponin negative group is 55 years both in male and female. in patients who were troponin rapid test positive,the coronary artery disease was found severe in 47(94%) patients,2 patients (4%) had moderate disease and one patient (2%) had mild disease. whereas 23(46%) had triple vessel disease,17(34%) double vessel disease and 10(20%) had single vessel disease. the main vessel involved in this group was lad which was found diseased in 44(88%) of patients. in patients who had troponin rapid test negative,disease was mild in 35(70%) of patients,8(16%) had moderate disease and 7(14%) had severe disease. the predominantly involved vessel was lcx in 47(94%) of cases. conclusion: our study revealed that the patients with troponin rapid test positive were having severe coronary artery disease involving multiple vessels mainly the lad in about 88% of patients. where as in patients with negative troponin rapid test the disease was mild in majority of cases and predominantly involved vessel was lcx. the disease was found severe in only 14% of patients in this group and this small group must be looked after properly and must receive aggressive medical treatment and must be considered for revascularization.