International Journal of Medical Advances and Discoveries

International Scholars Journal of Medical Advances and Discoveries | Vol. 16, No. 2, February 2025 | pp. 1–8

DOI: 10.46882/2025/IJMAD/000101

Original Research Article

Title: Evaluation of Myocardial Infarction Outcomes Using High-Sensitivity Troponin T Thresholds in Emergency Settings

Names of Authors: A. B. Mensah¹, C. D. Okoye², E. F. Smith³

Authors’ Affiliations: ¹Department of Cardiology, University Teaching Hospital, Lagos, Nigeria; ²Department of Emergency Medicine, National Medical Center, Abuja, Nigeria; ³Biostatistics Unit, Global Health Research Institute, London, UK

Abstract: The rapid evaluation of acute chest pain remains a central challenge in emergency cardiovascular care. This prospective multi-center study assessed the diagnostic performance and prognostic utility of optimized high-sensitivity troponin T (hs-TnT) thresholds in triaging patients presenting with suspected acute myocardial infarction. Over a twelve-month surveillance period, clinical data and serial blood samples were collected from 1,240 adult participants within a mean time of 1.5 h from admission. Patients were categorized using a baseline cutoff of 14 ng/L versus an accelerated 0/1-hour algorithm incorporating a delta change of > 5 ng/L. Results demonstrated that the accelerated protocol achieved a diagnostic sensitivity of 96.4% (95% CI, 94.2% - 98.1%) and a negative predictive value of 99.1%, effectively ruling out non-ST-elevation myocardial infarction earlier than standard 3-hour testing. Mean length of stay in the emergency department decreased by 2.4 ± 0.8 h (P < 0.001) without any elevation in 30-day major adverse cardiac events among early discharges. Subgroup analysis revealed consistent efficacy across diverse demographic profiles, though specificity was moderately lower in patients with chronic renal impairment (eGFR < 60 mL/min/1.73 m²). Cost-utility estimation further indicated a 15% reduction in overall inpatient bed utilization costs per episode. These findings support the widespread adoption of accelerated hs-TnT protocols to streamline acute coronary syndrome management pathways, reduce overcrowding in emergency departments, and maintain high safety margins for early patient disposition in resource-limited or high-volume clinical environments.

Keywords: Acute coronary syndrome; High-sensitivity troponin T; Emergency triage; Diagnostic accuracy; Myocardial infarction

Manuscript Timeline: Received: 12 October 2024; Revised: 04 January 2025; Accepted: 18 January 2025; Published: 05 February 2025

Citation: Mensah, A. B., Okoye, C. D., & Smith, E. F. (2025). Evaluation of Myocardial Infarction Outcomes Using High-Sensitivity Troponin T Thresholds in Emergency Settings. International Journal of Medical Advances and Discoveries, 16(2), 1–8.

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