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
Wessman, T. LU ; Zorlak, A. LU ; Wändell, Per LU ; Melander, O. LU
; Carlsson, Ac
and Ruge, T.
LU
(2023)
In BMC Emergency Medicine
23(1).
- 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... (More)
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.
(Less)
- author
- Wessman, T.
LU
; Zorlak, A.
LU
; Wändell, Per
LU
; Melander, O.
LU
; Carlsson, Ac
and Ruge, T.
LU
- organization
- publishing date
- 2023-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Congestive heart failure, Emergency department, High-sensitivity cardiac troponin T, Myocardial injury
- in
- BMC Emergency Medicine
- volume
- 23
- issue
- 1
- article number
- 40
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:37016316
- scopus:85151806739
- ISSN
- 1471-227X
- DOI
- 10.1186/s12873-023-00787-w
- language
- English
- LU publication?
- yes
- additional info
- 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).
- id
- 6bae826a-e74f-48d8-9e8b-22c187c65a2e
- date added to LUP
- 2024-01-12 15:13:25
- date last changed
- 2024-04-13 08:40:45
@article{6bae826a-e74f-48d8-9e8b-22c187c65a2e,
abstract = {{<p>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.</p>}},
author = {{Wessman, T. and Zorlak, A. and Wändell, Per and Melander, O. and Carlsson, Ac and Ruge, T.}},
issn = {{1471-227X}},
keywords = {{Congestive heart failure; Emergency department; High-sensitivity cardiac troponin T; Myocardial injury}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Emergency Medicine}},
title = {{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}},
url = {{http://dx.doi.org/10.1186/s12873-023-00787-w}},
doi = {{10.1186/s12873-023-00787-w}},
volume = {{23}},
year = {{2023}},
}