Prevalence, Characteristics and Outcomes of People Aged 65 Years and Over with an Incidental Rise in Cardiac Troponin I

Myint, Phyo Kyaw; Al-Jawad, Muna; Chacko, S M; Chu, Geoffrey; Vowler, Sarah L.; May, Helen

doi:10.1159/000109408

Cited by 15 publications

(9 citation statements)

References 43 publications

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“…This MACCE denotes that elevated troponin in non-cardiac conditions confers a significant implication at 6 months clinical outcomes and is not to be ignored. Our findings are in agreement with the result of a recent cross-sectional study of high-sensitivity cardiac troponins T which concluded that Significant illnesses apart from the acute coronary syndrome acute coronary syndrome as recent research has shed light on many other medical causes of troponin rise besides the ACS [29][30][31][32][33][34][35][36][37][38][39][40][41]. Troponin elevation was also reported in healthy young adults and children [33].…”

Section: Discussionsupporting

confidence: 90%

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

AlQassas¹,

Walid²,

Nadia³

et al. 2019

Int J Clin Cardiol

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Background: Several studies have linked elevated cardiac troponin to increased overall risk in patients with acute coronary syndrome but the prognostic significance of elevated troponin in non-cardiac conditions remains scanty. Objectives:The primary aim of this study was to investigate the prognostic significance of elevated high sensitivity troponin T (TnT-HS) in non-cardiac disorders outside the remit of an acute coronary syndrome (ACS). Secondarily we aimed to investigate the impact of cardiovascular comorbidities and other clinical presentations in the release of cardiac biomarkers in non-cardiac disorders.Methodology: This was a retrospective electronic patient record pilot review where all patients with elevated TnT-HS without acute coronary syndrome, recent angioplasty or heart failure within a three month period were enrolled into the study and subsequently followed prospectively for a six month period. From January 1, 2016 to June 30, 2016, a total of 2535 patients were screened of which 306 patients had elevated TnT-HS and 162 patients met the study inclusion criteria.Data were encrypted and collected in Google database format, exported into excel spreadsheet, analyzed and computed using SPSS (version 24) to identify clinical associations with increased values of TnT-HS.Results: Most troponin TnT-HS samples (77.1%) were obtained from emergency room (ER) attendance and 63.4% of patients were male. The mean age was 72 years and no Conclusions: TnT-HS positivity should be cautiously interpreted in patients exhibiting non acute cardiac conditions associated CKD, infections, and CVAs. This troponin elevation in non-cardiac conditions still carries a significant adverse prognosis.After adjusting for age and renal insufficiency, we can suggest a new cut off level of TnT-HS > 30 ng/l to have increased risk of MACCE within 180 days in non-cardiac conditions.

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Section: Discussionsupporting

confidence: 90%

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

AlQassas¹,

Walid²,

Nadia³

et al. 2019

Int J Clin Cardiol

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“…ACS is also more prevalent in older age, and recent work by our group4 5 and others3 suggests that even a minimal rise in troponin may be associated with worse outcomes in older patients. Therefore, it is likely that a troponin rise in older age may have a different prognostic value compared with those who are younger and may vary even within the older age spectrum.…”

Section: Introductionmentioning

confidence: 88%

Prognostic value of troponins in acute coronary syndrome depends upon patient age

Myint

Kwok

Bachmann

et al. 2014

Heart

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“…In an Observational Prospective Co hort Study, Myint et al (52) found 54% patients with a raised cTnI due to non-ACS illnesses. In the emer gency department, there were 42.2% patients with positive cTnI levels.…”

Section: B) No-ami Cardiac Injurymentioning

confidence: 99%

False Positive Troponin – A True Problem

Koraćević¹,

Ćosić²,

Stojanović³

2013

Journal of Medical Biochemistry

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Summary Cardiac troponins have a crucial role in diagnosing acute myocardial infarction, but have been considered by some authors to have a high false positive rate. Such opinions may decrease the confidence in troponin with important clinical consequences. The aim of the paper is to analyze three different meanings of the phrase »false positive troponin«: A) analytic (technical) false positive, with no real myocardial damage; B) false positive considering AMI: cardiac injury is present, but there is no AMI; C) false positive considering CAD: there is myocardial damage, but no CAD. The most frequent and the most important source of misunderstanding is the confusion between aspects A) and B). Namely, there has been a relatively small percentage of false positive troponin elevations due to analytic reasons. On the contrary, there has been a re - latively large percentage of »false positive« results in patients with myocardial necrosis due to causes other than AMI; for them - instead of »FP troponin elevation« - another phrase ought to be used, e.g., »non-AMI troponin elevation « until the etiopathogenesis in an individual patient is recognized. The phrase »false positive troponin« should be restricted to the artificial increase in troponin due to preanalytic and analytic reasons. By doing so, we may decrease the degree of confusion about troponin and increase the confidence in this highly specific marker of myocardial injury. The possibility of an analytic false positive result should always be kept in mind when one interprets elevated troponin.

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Prevalence, Characteristics and Outcomes of People Aged 65 Years and Over with an Incidental Rise in Cardiac Troponin I

Cited by 15 publications

References 43 publications

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

Prognostic value of troponins in acute coronary syndrome depends upon patient age

False Positive Troponin – A True Problem

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