To evaluate the long term prognosis (6 months of follow up) regarding mortality , acute myocardial infarction and coronary angiography results in patients with troponin positive or negative in high risk unstable angina pectoris .
All patients included in this study were adults, 73 patients, 52(71.24%) male versus 21(28.76%) female of different ages . All had clinical features of ischemic chest pain of high risk unstable angina. They attended private clinic in HIT city, Anbar Governorate ( West of Iraq ) during the period January 2010 – December 2012. All had planner ST-segment depression in electrocardiography (ECG) according to concordant ECG leads other ECG findings of T- wave inversion or ST- elevation myocardial infarction were excluded, measurement of serum troponin test was done for all patients. All patients included in the study were admitted to coronary care unit (CCU) and received full treatment including heparin and discharged from hospital when they were clinically stable. Coronary angiography was done for all patients and followed up for 6 months.
From all patients included in this study 27(36.98 % ) were troponin positive unstable angina, 3 (11.12%) patients of them were died and 24 (88.88 % ) patients of them survived. Their coronary angiography were sever type in 11(40.74 %) patients and they did coronary artery bypass surgery(CABG) and 13(48.14 % ) patients had multiple lesions in more than one vessels and need more than one balloon and stent(Percutaneous trans luminal coronary angioplasty PTCA) .While those whom troponin negative unstable angina were 46( 63.02 %) patients all were survived, only 5 (10.86 %) of them need coronary artery bypass surgery, 27 (58.69 %) patients need single or multiple stents , 4(11.5 %) patients had non critical coronary artery lesion only for medical treatment and the remaining 11 ( 41.81 %) patients were had normal coronary angiography .
Troponin positive high risk unstable angina carry poor prognosis where has 3 times more mortality risk and more likely to be in need for surgery and difficult stenting and may not be able to be treated surgically or by stenting but medically without intervention than negative troponin high risk unstable angina .