Prognostic Value of Megatroponinemia After Myocardial Infarction

Purpose: The purpose of this study is to investigate the prognostic value of megatroponinemia (troponins >100 ng/mL), as a predictor of major adverse cardiac events such as recurrent angina, myocardial infarction, and death in patients presenting with acute myocardial infarction. Methods: Over a period of 2 years, we identified 27 patients admitted with acute myocardial infarction and troponin I values >100 ng/mL. These patients were followed-up for the short term during their hospitalization as well as for an intermediate term of 18 ± 14 months after their initial presentation with acute myocardial infarction for major adverse cardiac events including recurrent angina, myocardial infarction, and death. Results: Of the 27 patients, one died 5 days after myocardial infarction and 26 were discharged home in stable condition, with few requiring timely intervention. Six patients were lost to follow-up. Five patients died during follow-up, 4 from recurrent myocardial infarction and 1 died from metastatic renal cell carcinoma. Twelve patients had non-fatal myocardial infarction, with 10 being acute ST elevation; 3 patients had recurrent angina. Conclusion: Patients presenting with an acute myocardial infarction and troponins >100 ng/mL have continued incremental risk of excessive major adverse cardiac events during short and intermediate follow-up period.