title: Elevated cardiac troponin levels do not predict adverse outcomes in hospitalized patients without clinical manifestations of acute coronary syndromes.
abstract: The prognostic significance of elevated cardiac troponin levels (CTL) in hospitalized patients with no other evidence of myocardial ischemia or injury is largely unknown. Fifty patients (mean age 61 +/- 15 years, 15 women) out of 580 consecutive hospitalized patients were selected based on normal CK-MB and at least 3-fold increase of CTL. The medical charts of these patients were reviewed and a 1-year follow-up was performed. The most frequent admission diagnoses were exacerbation of congestive heart failure (22%), stroke (20%) followed by respiratory failure (6%), cirrhosis (6%), gastrointestinal bleeding (6%), end-stage renal disease (4%), atrial fibrillation (4%) and metastatic malignancies (4%). Abnormal CTL prompted a cardiology consult in 48% of patients, an echocardiogram in 44%, myocardial perfusion study in 10% and coronary angiography in 1 patient. Of 21 deaths, only 1 was related to an acute coronary event. The measurement of CTL in patients without definite clinical or electrocardiographic evidence of myocardial ischemia and with a wide spectrum of clinical diagnoses does not predict in-hospital and at 1 year cardiovascular complications and/or cardiac death.
authors.affiliation: University of Texas, Houston Medical School, Houston, TX 77030, USA.
authors.forename: E
authors.initials: E
authors.lastname: Barasch
authors.forename: V
authors.initials: V
authors.lastname: Kaushik
authors.forename: R
authors.initials: R
authors.lastname: Gupta
authors.forename: P
authors.initials: P
authors.lastname: Ronen
authors.forename: B
authors.initials: B
authors.lastname: Hartwell
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003402:Creatine Kinase / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007118:Immunoassay; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D009206:Myocardium / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D020107:Troponin T / Q000097:blood*
chemical_list: D007527:Isoenzymes; D020107:Troponin T; D003402:Creatine Kinase