Assessment of the Role of Total Antioxidant Capacity and Troponin I as Possible Predictors for Phosphides -Induced Cardiotoxicity

Background: Metal phosphides are type of rodenticides that are extremely lethal with low safety and high mortality rates. They are commonly used as a powerful suicidal tool in Egypt and developing countries due to its low price and easy availability. Heart is a significant target organ of acute metal phosphides toxicity, causing myocardial damage and myocarditis. Aim: The study aimed to evaluate usefulness of total antioxidant capacity (TAC) and troponin I as predictive biomarkers for phosphides induced oxidative stress and cardiotoxicity among patients admitted to the Poison Control Center Ain Shams University Hospitals (PCC-ASUH). Methods and results: A prospective study included patients of both sexes presented to the PCC-ASUH with acute metal phosphides poisoning during six months period from July to December 2017. The demographic, intoxication and clinical data were collected for every patient. On admission investigations included electrocardiogram (ECG) in addition to TAC and troponin I levels. Outcome was also recorded.This study was conducted on 188 patients of both sexes with acute metal phosphides poisoning. The patients were classified according to the Poisoning Severity Score (PSS) into three groups; mild, moderate and severe. TAC value was significantly decreased in patients who developed cardiovascular manifestations and ECG abnormalities. Serum troponin I value was significantly higher in patients who developed cardiovascular manifestations and ECG abnormalities. Conclusion: The current study concluded that TAC and troponin I levels could be useful in predicting development of oxidative damage, cardiotoxicity and mortality after acute metal phosphides poisoning. Recommendations: The present study recommended the use of TAC and troponin I as useful markers for prediction of cardiotoxicity and mortality in patients with acute metal phosphides poisoning.