Prognostic value of cardiac troponin I assay in hospitalized elderly patients.
Aging Clin Exp Res. 2018 May 04;:
Authors: Attanasio F, Carrer P, Zurlo A, Rossi A, Babuin L, Mion MM, Zaninotto M, Plebani M, Iliceto S, Manzato E, Giantin V
BACKGROUND: Cardiac troponin I (cTnI) has been poorly studied in elderly inpatients.
AIM: This study wanted to assess factors influencing the increase in cTnI and its prognostic value in hospitalized elderly patients.
METHODS: 354 elderly (mean age of 84.8 ± 6.9 years) patients consecutively admitted in the Geriatrics Division in Padua were tested for cTnI levels assay during the hospital stay. Number of subsequent patient deaths at 6 months and 2 years were registered.
RESULTS: Of the 354 patients, 27 (7.6%) died in hospital; their levels were not significantly higher or more frequently positive on cTnI than those of the remainder of the sample. 71 (20.01%) patients died within 6 months of being discharged, and in-hospital positive cTnI levels emerged as a mortality risk factor in this group [unadjusted HR 1.13 (1.04-1.23); p = 0.004]. At 2 years, a total of 174 patients (49.2%) had died, but in-hospital pathological cTnI levels were not a mortality risk factor in this group.
DISCUSSION: It should be noted that cTnI level was a risk factor for mortality at 6 months but no longer at 2 years after an elderly patient's hospitalization. This finding may relate to patients' limited physiological reserves or be driven by the fact that the elderly tend to receive fewer evidence-based treatments, and to be managed more conservatively than younger patients.
CONCLUSIONS: In the multidimensional analysis of older patients, troponin I can be used to stratify patients and assess mortality risk at 6 months, but not at 2 years.
PMID: 29728985 [PubMed - as supplied by publisher]