title: Troponin T is a strong marker of mortality in hospitalized patients.
abstract: BACKGROUND
  Cardiac troponins are diagnostic markers in acute coronary syndrome and prognostic markers in stable coronary disease. Small increases are occasionally observed in patients with non-cardiac disease, but the prevalence and prognostic value of increased troponin in the general hospitalized population are unknown.
  
  
  METHODS
  Consecutive patients aged >40 years admitted to a district hospital between 1 April 1998 and 31 March 1999 were included. A comprehensive medical interview and clinical examination were performed including echocardiography and measurement of natriuretic peptides and troponin T with a high-sensitivity assay (hs-TnT).
  
  
  RESULTS
  Serum for analyses of hs-TnT was available from 1176 patients. Patients were 73.7 years old on average (interquartile range, 64.5-80.0 years), 59.2% were women and median follow-up was 11.4 years. The prevalence of elevated hs-TnT (> 99(th) percentile) was 57.1% of the entire cohort and 52.3% of patients with non-cardiac diagnoses. hs-TnT above the median (17 ng/L) was associated in univariate analysis with a 3-fold higher mortality in the entire population (multivariate hazard rate (HR) from 1.3 to 1.8 for 1 and 11 year mortality, respectively). In patients without past or present ischemic heart disease hs-TnT in the upper quartile (above 34.8 ng/L) was associated in univariate analysis with a 5-fold higher mortality risk (multivariable HR 1.8 to 2.2 for 1 and 11 year mortality, respectively).
  
  
  CONCLUSIONS
  More than half of the hospitalized patients had hs-TnT levels above the 99(th) percentile. Elevated hs-TnT is a strong mortality risk marker in general hospitalized older patients.
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of Cardiology and Endocrinology, Hillerød Hospital, Hillerød, Denmark. Electronic address: Kasper.iversen@dadlnet.dk.
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Gøtze
authors.forename: Morten
authors.initials: M
authors.lastname: Dalsgaard
authors.forename: Henrik
authors.initials: H
authors.lastname: Nielsen
authors.forename: Søren
authors.initials: S
authors.lastname: Boesgaard
authors.forename: Morten
authors.initials: M
authors.lastname: Bay
authors.forename: Vibeke
authors.initials: V
authors.lastname: Kirk
authors.forename: Olav Wendelboe
authors.initials: OW
authors.lastname: Nielsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: Mortality; Natriuretic peptides; Troponin