title: Prevalence and significance of troponin elevations in patients without acute coronary disease.
abstract: BACKGROUND
  Cardiac troponin T and I are important diagnostic and prognostic markers in patients with acute coronary syndrome (ACS). Troponin elevations in various non-ACS scenarios have been documented, but few studies have been conducted on the general hospitalized population, none compared the diagnostic performance of troponin I and T.
  
  
  RESULTS
  Patients aged >18years (n=1097), consecutively admitted to a district hospital, were included in the study. Blood samples were collected at admission and analysed with three different troponin assays. Serum was available in 92.2%, giving a study population of 1012 patients (mean age 61.6years, 510 (50.4%) female). ACS was diagnosed among 125 (12.4%) of the patients. Remaining patients were admitted with a broad spectrum of medical and surgical conditions. Of the total population, sc-cTnI was above the 99th percentile in 93 (9.2%), hs-cTnI was above the 99th percentile in 80 (7.9%) and hs-cTnT was above the 99th percentile in 400 (39.5%) of the patients (p<0.001 for all differences). Hs-cTnT was stronger correlated with estimated glomerular filtration rate (r [2]=0.13 vs r [2]=0.06) and haemoglobin (r [2]=0.1 vs r2=0.02) than with hs-cTnI, none were correlated with C-reactive protein (r [2]=0.04 vs r [2]=0.02). The correlation between ln(hs-cTnT) and ln(hs-cTnI) was better in ACS patients than in non-ACS patients (r [2]=0.79 vs r [2]=0.47, p<0.001).
  
  
  CONCLUSIONS
  Hs-cTnT was elevated above the 99th percentile in more than one third of the non-ACS patients, while hs-cTnI and sc-cTnI were elevated in approximately one tenth. The correlation between hs-cTnT and hs-cTnI concentrations was significantly stronger in ACS patients than in non-ACS patients.
authors: Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark. Electronic address: kirstinerv@gmail.com.
authors: Kirstine Roll
authors: KR
authors: Vestergaard
authors: Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark.
authors: Camilla Bang
authors: CB
authors: Jespersen
authors: Department of Cardiology, Herlev Hospital, Herlev, Denmark.
authors: Asthildur
authors: A
authors: Arnadottir
authors: Department of Clinical Biochemistry, Nordsjællands Hospital, Hillerød, Denmark.
authors: György
authors: G
authors: Sölétormos
authors: Department of Cardiology, Herlev Hospital, Herlev, Denmark.
authors: Morten
authors: M
authors: Schou
authors: Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark.
authors: Rolf
authors: R
authors: Steffensen
authors: Department of Clinical Biochemistry, Rigshospitalet, København, Denmark.
authors: Jens P
authors: JP
authors: Goetze
authors: Department of Cardiology, Herlev Hospital, Herlev, Denmark.
authors: Erik
authors: E
authors: Kjøller
authors: Department of Cardiology, Herlev Hospital, Herlev, Denmark.
authors: Kasper K
authors: KK
authors: Iversen
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D015995:Prevalence; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T
keywords: Coronary disease; Diagnosis; Myocardial infarction