Assessing Lipid Profile’s Role in Troponin I Positivity Among Patients Presenting with Chest Pain

Abstract

Background: Distinguishing myocardial infarction (MI) from other causes of acute chest pain is essential due to the distinct treatment needs and outcomes. While ST-segment elevation on ECG is particular for MI, its limited sensitivity can result in missed diagnoses. This study investigates whether lipid profile parameters could serve as additional markers for myocardial injury, enhancing risk assessment, particularly in cases with inconclusive ECG results.

Aim and Objectives: To evaluate the relationship between lipid profiles and troponin I levels in patients presenting with acute chest pain and whether lipid markers can enhance diagnostic accuracy for myocardial injury.

Material and Methods:This prospective observational study was conducted in a tertiary care teaching hospital in Gujarat, India, from March 2019 to February 2021. The study enrolled 200 patients over the age of 20 presenting with chest pain, divided into two groups based on troponin I levels: 100 patients with elevated troponin I (≥0.004 mg/dL) and 100 with normal levels (<0.001 mg/dL). Lipid parameters, including total cholesterol, triglycerides, LDL, HDL, and VLDL, were analyzed, with direct LDL measurements taken for accuracy. Continuous variables were analyzed using descriptive and inferential statistics. Mean and standard deviation values were reported, and statistical tests determined significance, using a p-value threshold of <0.05.

Results: Significantly higher levels of total cholesterol, triglycerides, LDL, HDL, and VLDL were observed in the troponin-positive group compared to the troponin-negative group (p < 0.001). Among troponin-negative patients, lipid parameters showed no significant differences by sex, except for VLDL, which was higher in males.

Conclusion: Elevated lipid levels in troponin-positive patients suggest an association between lipid abnormalities and myocardial injury. The findings indicate that lipid profiling, in combination with troponin I levels, may improve diagnostic precision and risk stratification in patients with acute chest pain.