TROPONIN T AS A NON-INVASIVE PREDICTOR OF SUCCESSFUL REPERFUSION AFTER THROMBOLYTIC THERAPY FOR ACUTE MYOCARDIAL INFARCTION
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Fifty patients with acute rrzyocardial infarction (AM!) were classified into: Group 1: 25 patients with AMI who received streptokinase (SK) within 6 hours from the onset of chest pain. Group H: 25 patients with Alla who did not receive SK .Of group 1 15 patients had successful reperfusion group (IA) and 10 patients failed to reperfuse group (1B).0f group II ,8 patients spontaneously reperfused group (HA) and 17 patients were permanently occluded. ST segment reduction and reperfusion arrhythrnias were significantly more in patients with successful reperfusion with a sensitivity of 60% and specificity of 90% for ST segment reduction and 47% and 100% respectively for reperfusion arrhythmias The curve plotted for troponin T (Tn77 serum levels in the successfully reperfused patients has a characteristic peak at 14 hours followed by a 4 plateau effect, with a persistent elevation of its level till the end of the study. In non reperfused patients , Tiff curve showed a continuous elevation of its level throughout the study which was higher than that of reperfused patients. There was a large increase in TnT serum concentrations above the detection limit which was much more than that of CK and CK- MB ( 5-33 folds vs 2 folds for CK and CK-MB). The sensitivity of TrIT for diagnosis of SAME was 100%, while for prediction of vessel patency the sensitivity was 95% and specificity was 91% The sensitivity and specificity for predic- tion of vessel patency was 75% and 80% for CIC and 83% and 85% for CK-MB respectively. From this study, TnT is a serum cardiac marker which allows non- invasive diagnosis of AMI and prediction of coronary artery patency which helps in decision making as regards further management.