Cross-sectional study of high-sensitivity cardiac troponins T and I in a hospital and community outpatient setting

Abstract

Objectives: Cardiac troponins are specific for the heart, but not for the acute coronary syndrome. We wanted to assess how common elevated cardiac troponin concentrations were, in a population with significant non-cardiac disease. Design & Methods: We measured both hs-cTnT and hs-cTnI on all samples submitted to the laboratory during one 24 h period, and assessed the magnitude of the cTn concentration with the location and severity of disease of the patient. Results: Community patients and patients from the maternity ward had the lowest cTn concentrations with results above the 99th percentile being only 0–2% of the total. As expected, the highest proportion of results N99th percentile came from Coronary Care and Intensive Care. However, substantial numbers of persons on Medical and Surgical wards, without a primary diagnosis of cardiac disease, also had cTn N99th percentile. Particularly for cTnT, there was a highly significant odds ratio predicting mortality when results above and below the 99th percentile were compared. Conclusions: Significant illnesses apart from the acute coronary syndrome are important causes of a rise in cTn to above the 99th percentile, and appear to reflect the total body burden of disease. Even when the high hs-cTn concentration is not due to the acute coronary syndrome, there is a significant association with all-cause mortality Show more