Causes of death in relation to stable troponin levels including chronic myocardial injury
Copyright © 2019 Elsevier B.V. All rights reserved..
BACKGROUND: Many patients presenting with chest pain in the emergency department have stable concentrations of high-sensitivity cardiac troponin T (hs-cTnT) without any acute medical condition. Stable hs-cTnT levels are associated with a high risk of death. This study aimed to investigate causes of death in relation to hs-cTnT concentrations.
METHODS: In a cohort of 19,460 patients with chest pain and stable hs-cTnT levels measured 2011-2014, of whom 1528 (7.9%) had chronic myocardial injury, we included all patients who died during follow-up (4.0 ± 1.3 years). Rates of cause-specific death were calculated for hs-cTnT concentrations and adjusted odds ratios (OR) estimated for causes of death at hs-cTnT 5-14 ng/l and >14 ng/l (referent hs-cTnT < 5 ng/l).
RESULTS: The study cohort comprised 1577 patients (8.1%), of whom 684 (43%) had chronic myocardial injury (hs-cTnT > 14 ng/l). Annual cardiovascular and non-cardiovascular death rates increased with increasing hs-cTnT from 0.07% and 0.4% (<5 ng/l) to 17% and 15% (≥50 ng/l), respectively. The ratio of cardiovascular to non-cardiovascular death increased with higher hs-cTnT. Patients with hs-cTnT 5-14 ng/l were 87% more likely to die from cardiovascular causes than those with hs-cTnT < 5 ng/l (adjusted OR: 1.87, 95% CI: 1.24-2.80). The association was similar for patients with chronic myocardial injury.
CONCLUSIONS: Hs-cTnT concentrations of 5-14 ng/l and >14 ng/l are associated with an almost twofold risk of cardiovascular death, whereas cardiovascular death almost never occurs in patients with undetectable troponin. Only with hs-cTnT concentrations ≥ 50 ng/l were cardiovascular diseases the predominant cause of death.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:306 |
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| Enthalten in: |
International journal of cardiology - 306(2020) vom: 01. Mai, Seite 133-139 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Roos, Andreas [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers |
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| Anmerkungen: |
Date Completed 19.05.2021 Date Revised 19.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2019.11.150 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM304152331 |
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| 245 | 1 | 0 | |a Causes of death in relation to stable troponin levels including chronic myocardial injury |
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| 500 | |a Date Revised 19.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Many patients presenting with chest pain in the emergency department have stable concentrations of high-sensitivity cardiac troponin T (hs-cTnT) without any acute medical condition. Stable hs-cTnT levels are associated with a high risk of death. This study aimed to investigate causes of death in relation to hs-cTnT concentrations | ||
| 520 | |a METHODS: In a cohort of 19,460 patients with chest pain and stable hs-cTnT levels measured 2011-2014, of whom 1528 (7.9%) had chronic myocardial injury, we included all patients who died during follow-up (4.0 ± 1.3 years). Rates of cause-specific death were calculated for hs-cTnT concentrations and adjusted odds ratios (OR) estimated for causes of death at hs-cTnT 5-14 ng/l and >14 ng/l (referent hs-cTnT < 5 ng/l) | ||
| 520 | |a RESULTS: The study cohort comprised 1577 patients (8.1%), of whom 684 (43%) had chronic myocardial injury (hs-cTnT > 14 ng/l). Annual cardiovascular and non-cardiovascular death rates increased with increasing hs-cTnT from 0.07% and 0.4% (<5 ng/l) to 17% and 15% (≥50 ng/l), respectively. The ratio of cardiovascular to non-cardiovascular death increased with higher hs-cTnT. Patients with hs-cTnT 5-14 ng/l were 87% more likely to die from cardiovascular causes than those with hs-cTnT < 5 ng/l (adjusted OR: 1.87, 95% CI: 1.24-2.80). The association was similar for patients with chronic myocardial injury | ||
| 520 | |a CONCLUSIONS: Hs-cTnT concentrations of 5-14 ng/l and >14 ng/l are associated with an almost twofold risk of cardiovascular death, whereas cardiovascular death almost never occurs in patients with undetectable troponin. Only with hs-cTnT concentrations ≥ 50 ng/l were cardiovascular diseases the predominant cause of death | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiac biomarker | |
| 650 | 4 | |a Chest pain | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Troponin | |
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| 650 | 7 | |a Troponin |2 NLM | |
| 650 | 7 | |a Troponin T |2 NLM | |
| 700 | 1 | |a Kadesjö, Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Sartipy, Ulrik |e verfasserin |4 aut | |
| 700 | 1 | |a Holzmann, Martin J |e verfasserin |4 aut | |
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