Cardiac Markers: Laboratory Pattern in a Tertiary Hospital in Rivers State, Nigeria

Abstract

The role of Cardiac markers cannot be over-emphasized when making a diagnosis of and classifying acute coronary syndrome (ACS). Ideally, all presenting patients should be immediately evaluated with a 12 lead ECG, however, there are atypical cases that do not have clear-cut (clinical and ECG) features. This poses a diagnostic challenge. One way to differentiate between the various classes of ACS and the causes of chest pain is by the presence or absence of elevated cardiac enzymes. This necessitates that cardiac markers are done when there is a strong clinical suspicion. There is sparse information about cardiac markers in southern Nigeria. Objectives: The study aimed to assess the patronage of the hospital laboratory in University of Port Harcourt Teaching Hospital Rivers State and the pattern of the results of cardiac markers. Methods: This was a retrospective study done over a period of 18months utilising data from Laboratory records in a tertiary hospital. Data from January 2022 to June 2023 was collected. Results: A total of 146 requests were received and 78.6% were within range. 4.1% had isolated elevation of troponin I, 6.9% had only CK MB raised, 2.8% had isolated increase of myoglobin. Less than 1% had all three raised. 4.8% had values over 6 times the upper limit of the reference interval. Correlation with clinical features and time of onset of illness was difficult to establish due to insufficient records. Conclusion: Cardiac markers should be assessed in all patients with suspected ACS and better collaboration between the clinician and the laboratory is strongly encouraged.