Prognostic implications of troponin I elevation in emergency department patients with tachyarrhythmia.
Clin Cardiol. 2019 Mar 20;:
Authors: González-Del-Hoyo M, Cediel G, Carrasquer A, Bonet G, Vásquez-Nuñez K, Boqué C, Alí S, Bardají A
BACKGROUND: Tachyarrhythmias are very common in emergency medicine, and little is known about the long-term prognostic implications of troponin I levels in these patients.
HYPOTHESIS: This study aimed to investigate the correlation of cardiac troponin I (cTnI) levels and long-term prognosis in patients admitted to the emergency department with a primary diagnosis of tachyarrhythmia.
METHODS: A retrospective cohort study was conducted between January 2012 and December 2013, enrolling patients admitted to the emergency department with a primary diagnosis of tachyarrhythmia and having documented cTnI measurements. Clinical characteristics and 5-year all-cause mortality were analysed.
RESULTS: Of a total of 222 subjects with a primary diagnosis of tachyarrhythmia, 73 patients had elevated levels of cTnI (32.9%). Patients with elevated cTnI levels were older and presented significantly more cardiovascular risk factors. At the 5-year follow-up, mortality was higher among patients with elevated cTnI levels (log rank test p <0.001). In the multivariable Cox regression analysis, elevated cTnI was an independent predictor of all-cause death (hazard ratio, 1.95, 95% confidence interval [CI]: 1.08-3.50, p= 0.026), in addition to age and prior heart failure.
CONCLUSION: Patients admitted to the emergency department with a primary diagnosis of tachyarrhythmia and high cTnI levels have higher long-term mortality rates than patients with low cTnI levels. cTnI is thus a biomarker with predictive capacity for mortality in late follow-up, conferring utility in the risk stratification of this population. This article is protected by copyright. All rights reserved.
PMID: 30895632 [PubMed - as supplied by publisher]