Abstract Introduction Timely reperfusion within 120 minutes is strongly recommended in patients presenting with non-ST segment myocardial infarction (NSTEMI) with very high-risk features. Evidence regarding the use of high sensitivity cardiac troponin (hs-cTn) concentration upon admission for the risk-stratification of patients presenting with NSTEMI in order to expedite percutaneous coronary intervention (PCI) and thus potentially improve outcomes is limited. Methods All patients admitted to a tertiary care center intensive cardiac care unit (ICCU) between July 2019 – July 2022 were included and were followed for up to 3 years. Hs-cTnI level on presentation was recorded and patients were divided into four quartiles according to their hs-cTnI level on admission. Association between the initial hs-cTnI level and all-cause mortality during the follow-up period was examined. Results A total of 544 NSTEMI patients with a median age of 67 were included. There was no difference between the initial hs-cTnI level groups regarding age and comorbidities. A higher mortality rate was observed in the highest hs-cTnI quartile as compared with the lowest hs-cTnI quartile (16.2% vs. 7.35%, p=0.03) with Hazard ratio (HR) for mortality of 2.6 (CI: 1.23-5.4; p=0.012). Conclusions Patients presenting with NSTEMI and higher Hs-cTnI levels on admission were at higher risk for mortality during follow-up. This finding supports further prospective studies to examine the impact of early reperfusion strategy on mortality in patients presenting with NSTEMI according to degree of troponin elevation on admission.

Troponin Level at Presentation as a Prognostic Factor Among Patients Presenting with non-ST Segment Elevation Myocardial Infarction