title: Association of mild transient elevation of troponin I levels with increased mortality and major cardiovascular events in the general patient population.
abstract: BACKGROUND
  The prognostic value of mild elevation of cardiac-specific troponin I (cTnI) levels is poorly defined, which can make interpretation of such an elevation difficult.
  
  
  OBJECTIVE
  To study the prognostic value of transient mild elevation of cTnI levels in the hospitalized patient population.
  
  
  METHODS
  We performed a case-control study that compared the outcome of patients hospitalized for any cause with at least 2 subsequent transient cTnI measurements of 0.1 ng/mL or higher and less than 1.5 ng/mL with matched controls with cTnI levels less than 0.1 ng/mL. A cohort of 118 patients (mean +/- SD age, 67.4 +/- 14.0 years; 35.6% men) was followed up for an average +/- SD of 11.9 +/- 7.9 months. Seventy-one cases were matched with 37 controls in terms of demographics, coronary artery disease risk factors, and reason for admission. End points were all-cause mortality and major cardiovascular end points, including cardiovascular mortality, myocardial infarction, and revascularization.
  
  
  RESULTS
  The total event rate was significantly increased in the case group compared with the control group at 12, 6, and 3 months (62.0% vs 24.3%, 59.2% vs 16.2%, and 47.9% vs 5.4%, respectively; P < .001). At 12, 6, and 3 months, the cases had a significant increase in all-cause mortality (43.7% vs 16.2%, 40.8% vs 8.1%, and 33.8% vs 0.0%, respectively; P = .005) and major cardiovascular end points (26.8% vs 8.1%, 26.8% vs 8.1%, and 21.1% vs 5.4%, respectively; P = .02) compared with controls.
  
  
  CONCLUSIONS
  Transient mild elevation of cTnI levels in hospitalized patients is associated with an increase in all-cause mortality and major cardiovascular complications. Such elevations of cTnI levels can be considered a marker for both all-cause and cardiovascular morbidity and mortality.
authors.affiliation: Division of Cardiology, Loyola University Medical Center, Maywood, Ill, USA. steinargud@yahoo.com
authors.forename: G Steinar
authors.initials: GS
authors.lastname: Gudmundsson
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Kahn
authors.forename: John F
authors.initials: JF
authors.lastname: Moran
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D011379:Prognosis; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I