Prevalence, characteristics and outcomes of people aged 65 years and over with an incidental rise in cardiac troponin I. An observational prospective cohort study.
BACKGROUND
Cardiac troponin I (cTnI) is a sensitive and specific marker of acute cardiac damage. We examined the prevalence, characteristics and outcome of incidental cTnI rises in older patients.


METHODS
One hundred and eighty-seven consecutive patients aged 65 years or over with a raised cTnI on admission at least 8 h after symptom onset were categorised into: (1) ST-elevation myocardial infarction, (2) other acute coronary syndromes (ACS), (3) other recognised non-ACS causes of cTnI rise and (4) non-ACS with no other identifiable cause (an incidental finding). The number of readmissions and deaths for each group was measured at 30 and 90 days.


RESULTS
Age range = 65-98 years. Male = 55.6%. Fifty-four percent had a raised cTnI due to non-ACS illnesses, whilst in 18% it was an incidental finding. The latter group was relatively older and had a significantly lower degree of cTnI rise (U = 1718.5, p = 0.002), but a higher readmission and mortality rate compared to the other groups (categories 1-3) for both follow-up periods.


CONCLUSIONS
Incidental cTnI rise is common in older patients and is associated with a poorer prognosis compared to ACS or a recognised non-ACS condition. Future research should attempt to evaluate the significance of such incidental rises in elderly patients.
Myint
Phyo K
PK
Department of Medicine for the Elderly, Norfolk and Norwich University Hospital, Norwich, UK. Pkyawmyint@aol.com
Al-Jawad
Muna
M
Chacko
Sanoj M
SM
Chu
Gavin S
GS
Vowler
Sarah L
SL
May
Helen M
HM
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D008297:Male; D019370:Observation; D015995:Prevalence; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D013997:Time Factors; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I