Association between cardiac troponin testing at scheduled admission and mortality in patients with comorbidities

Abstract

Background: Cardiac troponin I (cTnI) is a gold-standard biomarker for detecting myocardial infarction.Recently, the prognostic role of cTnI was reported for stable coronary artery disease and other chronic diseases. This study aimed to evaluate the usefulness of cTnI testing at scheduled admission of patients with comorbidities.Methods: We retrospectively enrolled patients with comorbidities who were admitted through the outpatient clinic from April 2010 to December 2018. The enrolled patients were divided into two groups depending on whether cTnI was measured at admission. The primary endpoint was the mortality rate at one year after admission. Secondary endpoints included 30-day and in-hospital mortality rates.Results: A population of 50,119 patients was divided into two groups, with 43,974 (87.8%) patients included in the no cTnI group and 6,145 (12.2%) patients included in the cTnI group. The multivariable analysis showed a reduction of mortality at one year in the cTnI group [5.9% vs. 3.8%, hazard ratio (HR) =0.78; 95% confidence interval (CI): 0.68-0.89; P<0.001]. Among 5,882 propensity score-matched pairs, this trend persisted, and the mortality rate was significantly lower in the cTnI group (5.3% vs. 3.9%, HR =0.77; 95% CI: 0.65-0.91; P=0.002). Patients with cTnI measurements taken at admission underwent cardiac evaluation and therapy more frequently. Conclusions:The measurement of cTnI at scheduled admission may affect the mortality during one year of follow-up. Further studies are needed to validate our results.

Application Cardiac Troponin in Cardiovascular Diseases Other Than Acute Coronary Syndrome: A Systematic Review

“…Oh, AR et al (2023) 9 showed the measurement of cTnI in relatively stable patients at scheduled admission to medical departments was associated with reduced mortality during one year of follow-up. This could be related to more active evaluation and treatment.…”

Troponin in non-cardiac department—finding a stray piece of puzzle?

“…The results of the Oh et al analysis (1) "Association between cardiac troponin testing at scheduled admission and mortality in patients with comorbidities" presents the utility of troponin I screening test basing on the analysis performed on 289,764 consecutive asymptomatic patients who were admitted from the outpatient clinic to non-cardiological/non-cardiac surgery departments.…”

“…Elevated or at upper normal range levels of troponin may be present in several acute or chronic diseases and associated with worse prognosis (10). Therefore, early changes in pharmacotherapy may influence the long-term outcomes which was underlined in the study by Oh et al (1). Troponin elevation was presented in acute decompensation and liver failure with increased mortality (11).…”