Background: Serum troponin is an exquisitely sensitive marker of myocardial injury and is necessary for establishing the diagnosis of Myocardial Infarction particularly non-ST elevation myocardial infarction (NSTEMI). However, the relation of troponin-I level with left ventricular systolic dysfunction following first episode of NSTEMI are still not examined in our population. Therefore, to determine the relationship of serum troponin I with left ventricular ejection fraction after first episode of NSTEMI was set as an objective of the study. Methods: This cross sectional analytical study was conducted on 160 patients. They were divided into the two groups (80 patients in each group): Group-A (Troponin I level e” 0.4 ng/ml) high risk group and Group-B (Troponin I level < 0.4 ng/ml) low risk group. Left ventricular systolic dysfunction was defined as ejection fraction (EF%) < 50% calculated by modified Simpson’s method on transthoracic echocardiography. Association of troponin-I level with left ventricular systolic function was determined. Results: Among a total 160 patients, no significant variation across the group A and B in terms of age, gender and occupation (p>0.05 in all cases). Median serum troponin I of group A was 7.24 (range: 0.41- 58.25) and group B was 0.21(range: 0.12-0.39). Left ventricular EF was significantly lower in higher troponin I group (Group A-45.95±10.28 vs. Group B-56.30±7.78; p<0.05) and it was associated with higher proportion of left ventricular dysfunction (p<0.05). Conclusion: Serum troponin-I can be considered as a predictor of the left ventricular systolic dysfunction in first episode of Non-ST elevation myocardial infarction patients. Cardiovasc j 2022; 15(1): 42-48

Background: Microalbuminuria may have an association with myocardial infarction in absence of traditional risk factors like diabetes. The present study was intended to find the association between microalbuminuria and angiographic severity of coronary artery disease in non-diabetic myocardial infarction patients. Methods: This cross sectional analytical study included 105 non-diabetic patients with myocardial infarction who underwent coronary angiography (CAG). The microalbuminuria was defined as urine albumin to creatinine ratio (ACR) of 30 -300 mg/g, while angiographic severity was measured by Gensini score with score e” 36 was taken as moderate to severe coronary artery disease (Group I) and score below 36 was termed as absent or mild coronary artery disease (Group II). Association of microalbuminuria with severity of coronary artery disease was determined. Results: Presence of microalbuminuria was found significantly higher (45%) in patients with moderate to severe coronary artery disease than that in patients with absent or mild CAD (4.6%). The Odds of having moderate to severe coronary artery disease in patients with microalbuminuria was observed to be 17 times (95% CI = 4.5 - 63) higher than that in patients without having this condition. Correlation between ACR and Gensini score was also found a significant positive relationship (r=0.702, p<0.001) with 70% of variation in Gensini score being explained by ACR. Conclusion: Microalbuminuria can be considered as a predictor of the severity of coronary artery disease in non-diabetic myocardial infarction patients. Cardiovasc j 2022; 15(1): 56-62

Background: Glycated hemoglobin (HbA1c) values reflect two to three months average endogenous exposure haemoglobin to glucose including postprandial spikes and have low intra-individual variability particularly in non-diabetic patients. Elevated HbA1c is regarded as an independent risk factor for coronary artery disease (CAD) in patients with or without diabetes mellitus (DM). The purpose of this study is to determine the correlation between the level of HbA1c and the severity of coronary artery disease in non-diabetic non ST elevation myocardial infarction (NSTEMI) patients. Methods: This observational study was carried out with total of 64 non-diabetic patients with a history of NSTEMI. Patients were divided into 2 groups based on HbA1c - one group having HbA1c ³5.7 – 6.4% (High risk group) and another group with HbA1c < 5.7% (Low risk group). Severity of CAD was assessed using Gensini score derived from coronary angiographic data. Gensini score < 36 points was regarded as mild coronary artery disease and Gensini score 36 points as moderate to severe coronary artery disease. Then patients with high and low risk HbA1C groups were correlated with severity of CAD. Results: Over 55.5% patients with HbA1c in high-risk group (5.7 – 6.4%) had severe CAD as opposed to 28.6% patients with HbA1c in low-Risk group (<5.7%). The individuals with high-risk group of HbA1c was 3.1 (95% of CI = 1.1 – 8.9) times more likely to have severe CAD than those with HbA1c < 5.7% (p = 0.031). Spearman correlation between HbA1c and Gensini score depicted that the two variables exhibit a linear relationship indicating that Gensini score rises parallel with the rise of HbA1c (r = 0.289, p = 0.021). Conclusion: The study concluded that over half of the non-diabetic, NSTEMI patients with high-risk range HbA1c are likely to have severe CAD than those with HBA1c within normal range. Cardiovasc j 2022; 15(1): 26-35