Clinical significance of unsuspected rise in cardiac troponin in the setting of falls in older people.
OBJECTIVE
To assess the clinical significance of unsuspected rise in cardiac troponin I (cTnI) levels in elderly patients who have fallen.


METHODS
Monocentre prospective observational pilot study.


METHODS
Consecutive elderly patients (age >65 years) referred to the emergency department after being immobilised on the ground after a fall.


METHODS
Clinical, laboratory and Doppler echocardiography data were collected on admission to assess the cardiac correlates of increased cTnI. The survival endpoint was a composite of death or cardiovascular event.


RESULTS
60 patients were included in this study. Mean age was 81+/-8 years. Cardiac TnI was > or =0.05 ng/ml in at least one blood sample in 40 patients (67%). New diagnosis of cardiac disease was performed in 14 patients, 13 of them had cTnI > or =0.05 ng/ml. Transient apical ballooning was diagnosed in six patients. During a median follow-up of 92 (49-131) days death occurred in six patients, myocardial infarction in three, stroke in one and acute heart failure in five. Cardiac TnI > or =0.05 ng/ml was a predictor of these events (p=0.034).


CONCLUSIONS
An unsuspected rise in cTnI correlates with new diagnosis of cardiac disease and is a potential marker of stress induced cardiomyopathy in elderly patients who fall. Cardiac TnI might be a strong predictor of outcome in these patients.
Maréchaux
Sylvestre
S
Department of Cardiology and Intensive Care Unit, CHRU de Lille, Lille cedex, France.
Lubret
Rémy
R
Delsart
Pascal
P
Hattabi
Medhi
M
Six-Carpentier
Marie-Michèle
MM
Carpentier
Emilie
E
Coutant
Véronique
V
Pinçon
Claire
C
Le Tourneau
Thierry
T
Puisieux
François
F
Goldstein
Patrick
P
Asseman
Philippe
P
Ennezat
Pierre Vladimir
PV
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D019411:Clinical Laboratory Techniques; D015150:Echocardiography, Doppler; D004636:Emergency Service, Hospital; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D054549:Takotsubo Cardiomyopathy / Q000097:blood / Q000175:diagnosis; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I