title: Clinical significance of unsuspected rise in cardiac troponin in the setting of falls in older people.
abstract: 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.
authors.affiliation: Department of Cardiology and Intensive Care Unit, CHRU de Lille, Lille cedex, France.
authors.forename: Sylvestre
authors.initials: S
authors.lastname: Maréchaux
authors.forename: Rémy
authors.initials: R
authors.lastname: Lubret
authors.forename: Pascal
authors.initials: P
authors.lastname: Delsart
authors.forename: Medhi
authors.initials: M
authors.lastname: Hattabi
authors.forename: Marie-Michèle
authors.initials: MM
authors.lastname: Six-Carpentier
authors.forename: Emilie
authors.initials: E
authors.lastname: Carpentier
authors.forename: Véronique
authors.initials: V
authors.lastname: Coutant
authors.forename: Claire
authors.initials: C
authors.lastname: Pinçon
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Tourneau
authors.forename: François
authors.initials: F
authors.lastname: Puisieux
authors.forename: Patrick
authors.initials: P
authors.lastname: Goldstein
authors.forename: Philippe
authors.initials: P
authors.lastname: Asseman
authors.forename: Pierre Vladimir
authors.initials: PV
authors.lastname: Ennezat
mesh_terms: 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*
chemical_list: D015415:Biomarkers; D019210:Troponin I