<![CDATA[ABSTRACT Background: High-sensitivity cardiac troponin (hs‑Tn) is a cornerstone biomarker in acute myocardial infarction. While its diagnostic role is well established, the prognostic value of peak hs‑Troponin I (hs‑TnI) on in-hospital outcomes remains variable. Objectives: To investigate the effect of peak hs-TnI levels on in-hospital mortality and length of stay among patients with STEMI (ST-segment elevation myocardial infarction) and NSTEMI (non ST-segment elevation myocardial infarction). Methods: This retrospective cohort study used data from the Acute Coronary Syndrome Registry of Dr. Saiful Anwar General Hospital, East Java, Indonesia, collected between July 2023 and December 2024. Adult patients with STEMI or NSTEMI who underwent at least two hs-TnI measurements during early hospitalization were included. Peak hs-TnI was defined as the highest value recorded from early serial measurements without a predefined sampling interval. Multivariable logistic regression analysis was performed to identify independent predictors of in-hospital mortality, and the association with length of hospital stay was evaluated using non-parametric correlation analysis. Results: Among 335 included patients, those who died during hospitalization had significantly higher peak hs-TnI levels than survivors (p < 0.001). After adjustment for age, Killip class, and CRUSADE score, peak hs-TnI remained independently associated with in-hospital mortality. Discriminative performance was modest (AUC 0.63). No significant association was found between peak hs-TnI levels and length of hospital stay Conclusions: Peak hs-TnI from early serial measurements is an independent predictor of in-hospital mortality in STEMI and NSTEMI but is not associated with length of hospital stay.]]>
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