title: Early and late mortality in hospitalised patients with raised cardiac troponin T.
abstract: OBJECTIVE
  Cardiac troponins are measured in acute coronary syndrome (ACS) and other conditions. The authors investigate the prognostic significance of cardiac troponin T (TnT) test and comorbid medical conditions.
  
  
  METHODS
  Consecutive patients admitted to the Aintree University Hospital, Liverpool, between 2 January 2004 and 29 February 2004 who had TnT measurement were included. Patients were separated into normal (<0.01 μg/l) or raised TnT levels (≥ 0.01 μg/l), and further categorised into: (1) normal TnT with unstable angina; (2) normal TnT with non-ACS; (3) raised TnT with ACS; and (4) raised TnT with non-ACS. Cox regression was used to identify prognostic variables, and logrank test to compare 7-year survival.
  
  
  RESULTS
  Of 1021 patients, 313 had raised TnT (195 ACS, 118 non-ACS) and 708 normal TnT (80 ACS, 628 non-ACS). Age (HR 1.06; 95% CI 1.05 to 1.07), congestive cardiac failure (HR 1.37; 95% CI 1.11 to 1.69), cerebrovascular disease (HR 1.37; 95% CI 1.10 to 1.71), chronic obstructive airway disease (HR 1.44; 95% CI 1.19 to 1.75), liver disease (HR 4.16; 95% CI 2.37 to 7.31), renal disease (HR 1.83; 95% CI 1.27 to 2.64), tumour (HR 1.39; 95% CI 1.07 to 1.79), lymphoma (HR 4.81; 95% CI 2.07 to 11.16), metastatic cancer (HR 3.55; 95% CI 2.32 to 5.45) and a higher Charlson's comorbidity score (HR 1.20, 95% CI 1.13 to 1.26) were adverse predictors. Both raised TnT with ACS (HR 1.92, 95% CI 1.54 to 2.39) and raised TnT with non-ACS (HR 2.37, 95% CI 1.87 to 3.00) were associated with worse survival. Raised TnT with non-ACS had a worse survival than raised TnT with ACS (p=0.001).
  
  
  CONCLUSIONS
  Hospitalised patients with raised TnT levels from any cause predicted a higher mortality than normal TnT, with worst survival in those without an obvious ACS.
authors.affiliation: Aintree Cardiac Centre, University Hospital Aintree, Liverpool, Merseyside L9 7AL, UK. peter.wong@doctors.org.uk
authors.forename: Peter Sze Chai
authors.initials: PS
authors.lastname: Wong
authors.forename: Julia Dawn
authors.initials: JD
authors.lastname: Jones
authors.forename: Reza
authors.initials: R
authors.lastname: Ashrafi
authors.forename: Omer
authors.initials: O
authors.lastname: Khanzada
authors.forename: Upul
authors.initials: U
authors.lastname: Wickramarachchi
authors.forename: Touran Heidi
authors.initials: TH
authors.lastname: Keen
authors.forename: Derek Richard
authors.initials: DR
authors.lastname: Robinson
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004739:England; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D013997:Time Factors; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T