Role of High-Sensitivity Cardiac Troponin and NT-proBNP in Predicting Short-Term Outcomes Following Acute Myocardial Infarction

Abstract

Background: Early risk stratification following acute myocardial infarction (AMI) is essential for identifying patients at increased risk of adverse clinical outcomes. High-sensitivity cardiac troponin (hs-cTn) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are established cardiac biomarkers reflecting myocardial injury and ventricular stress, respectively.

Methods: This prospective observational study included 80 patients with AMI admitted to a tertiary care hospital. Baseline hs-cTn and NT-proBNP levels were measured at admission. Patients were followed for 30 days to assess composite adverse outcomes, including acute heart failure, cardiogenic shock, recurrent myocardial infarction, significant arrhythmias, prolonged hospital stay, and all-cause mortality. Receiver operating characteristic (ROC) analysis and multivariable logistic regression were performed to evaluate the prognostic performance of the biomarkers.

Results: Composite adverse outcomes occurred in 29 (36.3%) patients. Patients with adverse outcomes had significantly higher hs-cTn (4826 ± 1928 vs. 2633 ± 1397 ng/L; p<0.001) and NT-proBNP levels (4212 ± 1836 vs. 1504 ± 864 pg/mL; p<0.001). NT-proBNP demonstrated superior predictive ability (AUC 0.901) compared with hs-cTn (AUC 0.842), while the combined biomarker model achieved the highest accuracy (AUC 0.936). Multivariable analysis identified NT-proBNP >2500 pg/mL, hs-cTn >3650 ng/L, and LVEF <40% as independent predictors of adverse outcomes.

Conclusion: Both hs-cTn and NT-proBNP were valuable prognostic biomarkers in AMI, with NT-proBNP showing superior predictive performance. Combined assessment of both biomarkers improved early risk stratification and may facilitate timely therapeutic interventions in high-risk patients.