Biochemical Assessment for Risk of Myocardial Infarction in Drug Naïve Hypertensive Patients

Abstract

Background: Myocardial infarction may go undetected as a catastrophic event leading to hemodynamic deterioration and sudden death. The role of cardiac makers in the prompt diagnosis of acute myocardial infarction AMI has been established especially in patient presenting with clinical features coronary artery disease, however, the use of known cardiac biomarkers in the risk assessment of MI in newly diagnosed patients with hypertension is unpopular. This study aimed to assess the risk for myocardial infarction using cardiac troponin I and Atherogenic indices in newly diagnosed drug naïve patients with hypertension. Methods: The cross-sectional descriptive study was conducted among one hundred and seventeen subjects ≥18years. Anthropometric measurements and physical examination were done. Atherogenic indices for cardiovascular risk were estimated alongside biochemical parameters including cardiac Troponin I, lipid profiles, urea/creatinine and blood glucose. Data obtained were analysed using SPSS version 26, at p <0.05. Results: Most of the respondents were within the fourth decade of life, mean age of 45.24 ± 15.89 years. There was a preponderance for female sex with a male to female ratio of 1:1.2. Commonly reported clinical symptoms were palpitations, chest pain, shoulder pain and fatigue. The prevalence of cardiac troponin I (cTnI) was 10.3%, overall dyslipidaemia prevalence 97.4%, commonest was hypertriglyceridemia, and commonest pattern was mixed dyslipidaemia 70.2%. The majority with high cTnI had high CVD risk classified with AIP and CRR1. AIP demonstrated strong positive correlations with CRR1 P<0.05. And cTnI is a strong predictor with good discrimination (AUC = 0.762) and balanced sensitivity (81.42%) and specificity (75%). Conclusion: Cardiac troponin I showed good risk assessment value. The presence of cTnI activities clearly indicates an ongoing myocadiac structural changes, demonstrating a strong predictive strength. Also, AIP was identified as most important atherogenic index in drug naïve hypertensives.