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Non - coronary predictors of elevated high-sensitive cardiac Troponin T (hs - cTnT) levels in an unselected emergency patient cohort.
Clin Cardiol. 2018 Jul 17;:
Authors: Berger M, Emir M, Brünnler T, Rockmann F, Lehmann R
Abstract
BACKGROUND: Aim of this study was to evaluate the predictors of hs-cTnT in a non-ACS patient cohort admitted to the emergency department.
METHOD: We performed a retrospective, single centre study encompassing in total 1003 patients. Individuals were retrospectively divided in ACS- and non-ACS patients by two independent investigators reviewing the medical records. In order to identify predictors of hs-cTnT elevation hazard ratios were calculated for age, gender, vital signs, cardiovascular risk factors, LVEF, serum levels of CRP, haemoglobin, and creatinine. Elevation of hs-cTnT was defined by exceeding 14ng/l (upper reference limit [URL]).
RESULTS: 987 patients were included while 25 patients were excluded because of missing data. 307 patients (31,4%) met the current guideline requirements of diagnosing an ACS, whereas 671 patients (68,6%) were hospitalized with excluded ACS. In the multivariate analysis age, anemia, CRP, creatinine and reduced systolic left ventricular ejection fraction were independent predictors of elevated troponin T levels in the non-ACS group. However, hypertensive systolic blood pressure, atrial fibrillation and tachycardia were not predictive for Troponin T elevation in non-ACS patients in this multivariate analysis.
CONCLUSIONS: In an unselected, non-ACS patient cohort age, chronic renal failure, inflammatory state, and reduced left ventricular systolic function were associated with hs-cTnT-levels above the upper reference limit. Rather, often supposed predictors as atrial fibrillation, hypertension, and tachycardia cannot sufficiently explain increased hs-cTnT in our study. Hence, further studies are needed to assess whether isolated hypertension, tachycardia, or atrial fibrillation sufficiently explain elevated hs-cTnT. This article is protected by copyright. All rights reserved.
PMID: 30019381 [PubMed - as supplied by publisher]