Common Causes of Troponin Elevations in the Absence of Acute Myocardial Infarction

Use of clinically based troponin underestimates the cardiac injury in non-cardiac surgery: a single-centre cohort study in 51,701 consecutive patients

“…Sepsis is similarly associated with release of troponin. 32 Again, we consider this unlikely since the main association between troponin and mortality is retained in elective surgery where the measurement is taken in the first 48 hr after surgery, a situation where the overwhelming presence of sepsis is rare.…”

A Review of Causes and Systemic Approach to Cardiac Troponin Elevation

“…There are many non-ACS causes of cTn elevation in the ICU. 22,50 The clinical significance of elevated cTn level in patients in the ICU has been reviewed. In one study, the frequency of cTn elevation and its association with mortality and length of ICU stay in 58 consecutive critically ill patients without ACS was reviewed.…”

Can late gadolinium enhancement by cardiovascular magnetic resonance identify coronary artery disease as the etiology of new onset congestive heart failure?

“…CAD accounts for two-thirds of new CHF cases [1] but was only present in 19% of our study. However, an elevated troponin is not exclusive to CAD and can be present in 20% of acute CHF and 34% of myocarditis [11]. The addition of a noninvasive coronary assessment by multi-detector computed tomography or CMR or an ischemic evaluation by stress CMR [31] to the LGE evaluation might have provided a more comprehensive and conclusive evaluation of CAD in new onset CHF.…”

“…Underlying coronary artery disease (CAD) and ischemia are responsible for approximately two-thirds of all systolic dysfunction [1] and delineating it from nonischemic causes has essential therapeutic [2,3,4] and prognostic [5,6,7,8] implications. The electrocardiogram (ECG) [9], presence of anginal chest pain [10], and elevated troponins [11] are unable to accurately differentiate ischemic from nonischemic cardiomyopathy (NICM).…”