European Journal of Cardiovascular Medicine

Background: Acute coronary syndrome (ACS) includes unstable angina, NSTEMI, and STEMI, all resulting from reduced myocardial blood flow, commonly due to plaque rupture and thrombosis. Early diagnosis relies heavily on electrocardiography (ECG) and cardiac biomarkers, particularly troponin I. This study assessed the correlation between various ECG changes and troponin I levels in patients presenting with chest pain to the emergency department. Methods: A cross-sectional study was conducted among 200 adult patients (>18 years) presenting with chest pain and specific ECG abnormalities over a 12-month period. ECG findings were categorized into ST-segment elevation, ST-segment depression, T-wave inversion, hyperacute T waves, and bundle branch block. Troponin I was measured using a rapid qualitative immunoassay. Demographic characteristics were analyzed to identify age and sex trends. Results: Of the 200 patients, 134 were male and 66 were female. The majority belonged to the 45–65-year age group (n=106). Troponin I positivity was seen in 76 males (56.7%) and 37 females (56%). Age-wise, troponin positivity was highest in the 45–65-year group (n=66), followed by >65 years (n=33) and <45 years (n=12). ST-segment elevation showed the strongest correlation with troponin I positivity (98%). Troponin positivity was also seen in patients with ST-segment depression (46%), hyperacute T waves (50%), T-wave inversion (33%), and bundle branch block (25%). Conclusion: ST-segment elevation on ECG is highly predictive of troponin I positivity and acute myocardial infarction. Middle-aged males demonstrated the highest burden of ACS. The combined use of ECG interpretation and troponin I testing remains essential for early identification and management of ACS in emergency care.