Prognostic value of cardiac troponin in elderly patients with paroxysmal supraventricular tachycardia: A multicenter study

Link to article at PubMed

Am J Emerg Med. 2023 Apr 29;69:167-172. doi: 10.1016/j.ajem.2023.04.041. Online ahead of print.


BACKGROUND: An elevated level of cardiac troponin I (cTnI) frequently accompanies an episode of supraventricular tachycardia (SVT). However, the predictive value of cTnI in elderly SVT patients has not been examined.

METHODS: We collected the electronic medical records of elderly SVT patients (over 65 years old) who visited four Taiwanese emergency departments over a 2-year period. The patients who underwent cTnI testing were included in the cohort and further categorized based on their cTnI results (positive or negative). The study's primary outcomes were the 5-year risks of major adverse cardiovascular events (MACE) and SVT recurrence.

RESULTS: One hundred and twenty-four patients met the inclusion criteria. Of these patients, 39 (31.5%) had a positive cTnI result, and 85 (68.5%) had a negative cTnI result. Patients with a positive cTnI result were older (p = 0.029) and had a longer hospital stay (p = 0.023) than those with a negative cTnI result. Multivariate analysis showed that age > 75 years (OR = 2.41; 95% CI 1.07-5.45; p = 0.034) was an independent predictor for cTnI elevation. In the survival analysis, no difference in the incidence of five-year MACE (p = 0.656) was observed between the cTnI-positive and cTnI-negative groups. Multivariate analysis revealed that a history of coronary artery disease was the only significant independent risk factor for MACE (HR = 4.30; 95% 95% CI 1.41-13.05; p = 0.010). For SVT recurrence, the multivariate analysis revealed that previous SVT (HR = 3.37; 95% CI 1.53-7.39; p = 0.002), smoking history (HR = 2.32; 95% CI 1.03-5.24; p = 0.043), and RFA treatment (HR = 0.20; 95% CI 0.06-0.65; p = 0.008) were significant independent predictors.

CONCLUSIONS: An increased cardiac troponin level may not effectively indicate the risk of MACE in elderly SVT patients. Physicians might want to be cautious when interpreting troponin test results for this specific patient group.

PMID:37149956 | DOI:10.1016/j.ajem.2023.04.041

Leave a Reply

Your email address will not be published. Required fields are marked *