Myocardial injury defined as elevated high-sensitivity cardiac troponin T is associated with higher mortality in patients seeking care at emergency departments with acute dyspnea

T. Wessman, A. Zorlak, Per Wändell, O. Melander, Ac Carlsson, T. Ruge

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Elevated levels of cardiac troponin T has been observed in patients seeking care at the emergency department (ED) presenting with chest pain but without myocardial infarction (MI). The clinical importance of this observation remains, however, still unclear. Our main aim was to study the role of cardiac troponin T in patients admitted to the emergency department with acute dyspnea, a group of patients with a high cardiovascular comorbidity, but no primary acute MI. Population and methods: Patients from the age of 18 seeking care at the ED for dyspnea, without an acute cardiac syndrome, and with a recorded assessment of high-sensitivity cardiac troponin T (hs-cTnT), were included (n = 1001). Patients were categorized into 3 groups by hs-cTnT level, i.e. <15, 15–100 and > 100 µg/l. Cox regression with Hazard Ratios (HRs) and 95% Confidence Intervals (CI) for 3-months mortality was performed, with adjustment for sex, age, respiratory frequency, saturation, CHF, renal disease, and BMI. Results: Fully adjusted HRs (95% CI) for 3-month mortality, with hs-cTnT < 15 µg/l as reference level, showed for hs-cTnT 15–100 a HR of 3.682 (1.729–7.844), and for hs-cTnT > 100 a HR of 10.523 (4.465–24.803). Conclusion: Elevated hs-cTnT seems to be a relevant marker of poor prognosis in patients with acute dyspnea without MI and warrants further validation and clinical testing.

Original languageEnglish
Article number40
JournalBMC Emergency Medicine
Volume23
Issue number1
DOIs
Publication statusPublished - 2023 Dec

Bibliographical note

Funding Information:
The study was supported by research grants from the Knut and Alice Wallenberg Foundation, Göran Gustafsson Foundation, theSwedish Heart- and Lung Foundation, the Swedish Research Council, the Novo Nordisk Foundation, Region Skåne, Skåne University Hospital and the Swedish Foundation for Strategic Research (IRC).

Publisher Copyright:
© 2023, The Author(s).

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Free keywords

  • Congestive heart failure
  • Emergency department
  • High-sensitivity cardiac troponin T
  • Myocardial injury

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