TROP-MI-STAGE is a multicenter retrospective diagnostic study designed to evaluate the role of high-sensitivity cardiac troponin I (hs-cTnI) in the diagnosis and clinical stage classification of acute myocardial infarction as defined by the stages of myocardial injury in CCS-AMI classification.

The study retrospectively analyzes biomarker data from patients diagnosed with AMI across multiple institutions, focusing on whether hs-cTnI levels-measured at specific time points-can reliably identify and stratify patients into AMI clinical stages (Stage 1 to Stage 4). It aims to correlate hs-cTnI kinetics and peak levels with clinical stage, presentation patterns, and outcomes.

This trial seeks to offer a biomarker-based alternative to imaging-heavy staging, potentially streamlining early diagnosis and therapeutic triage for AMI patients in varied clinical settings.

Inclusion Criteria:

• Age 18-79 years
• Index STEMI
• Coronary angiogram with PCI to occur irrespective of the onset of the symptoms.
• Ability to provide informed consent for themselves

Exclusion Criteria:

• History of prior myocardial infarction,
• Cardiogenic shock,
• Patients who present with current cardiac arrest
• Any contraindication to cardiac CMR (claustrophobia, pacemaker or cardiac defibrillator, known allergy to gadolinium),
• Presence of permanent atrial fibrillation,
• Unconscious patient,
• Severe renal insufficiency (creatinine clearance ≤ 30 ml/min/m2 or renal replacement therapy),
• Women who are pregnant or breastfeeding. Women of reproductive potential must have a negative pregnancy test.

The study population consists of individuals aged 18 to 80 who have been diagnosed with acute ST-elevation myocardial infarction (STEMI) and are scheduled for emergency percutaneous coronary intervention (PCI).