Prevalence and significance of troponin elevations in patients without acute coronary disease

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• 作者：Kirstine Roll Vestergaard ; MD^a ; ^{kirstinerv@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Camilla Bang Jespersen^a (MD) ; Asthildur Arnadottir ; MD^b ; Gy&ouml ; rgy S&ouml ; lé ; tormos ; MD ; DMSc^c ; Morten Schou ; PhD^b (Associate Professor) ; Rolf Steffensen ; MD^a ; Jens P. Goetze ; DMSc^d (Professor) ; Erik Kjø ; ller ; MD ; DMSc^b ; Kasper K. Iversen ; MD ; DMSc^b (Associate Professor)
• 关键词：Diagnosis ; Myocardial infarction ; Coronary disease
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 November 2016
• 年：2016
• 卷：222
• 期：Complete
• 页码：819-825
• 全文大小：1014 K

文摘

Cardiac troponin T and I are important diagnostic and prognostic markers in patients with acute coronary syndrome (ACS). Troponin elevations in various non-ACS scenarios have been documented, but few studies have been conducted on the general hospitalized population, none compared the diagnostic performance of troponin I and T.

Methods and results

Patients aged > 18 years (n = 1097), consecutively admitted to a district hospital, were included in the study. Blood samples were collected at admission and analysed with three different troponin assays. Serum was available in 92.2%, giving a study population of 1012 patients (mean age 61.6 years, 510 (50.4%) female).

ACS was diagnosed among 125 (12.4%) of the patients. Remaining patients were admitted with a broad spectrum of medical and surgical conditions. Of the total population, sc-cTnI was above the 99th percentile in 93 (9.2%), hs-cTnI was above the 99th percentile in 80 (7.9%) and hs-cTnT was above the 99th percentile in 400 (39.5%) of the patients (p < 0.001 for all differences). Hs-cTnT was stronger correlated with estimated glomerular filtration rate (r [2] = 0.13 vs r [2] = 0.06) and haemoglobin (r [2] = 0.1 vs r2 = 0.02) than with hs-cTnI, none were correlated with C-reactive protein (r [2] = 0.04 vs r [2] = 0.02).

The correlation between ln(hs-cTnT) and ln(hs-cTnI) was better in ACS patients than in non-ACS patients (r [2] = 0.79 vs r [2] = 0.47, p < 0.001).

Conclusion

Hs-cTnT was elevated above the 99th percentile in more than one third of the non-ACS patients, while hs-cTnI and sc-cTnI were elevated in approximately one tenth. The correlation between hs-cTnT and hs-cTnI concentrations was significantly stronger in ACS patients than in non-ACS patients.