title: Cross-sectional study of high-sensitivity cardiac troponins T and I in a hospital and community outpatient setting.
abstract: OBJECTIVE
  Cardiac troponins are specific for the heart, but not for the acute coronary syndrome. We wanted to assess how common elevated cardiac troponin concentrations were, in a population with significant non-cardiac disease.
  
  
  METHODS
  We measured both hs-cTnT and hs-cTnI on all samples submitted to the laboratory during one 24h period, and assessed the magnitude of the cTn concentration with the location and severity of disease of the patient.
  
  
  RESULTS
  Community patients and patients from the maternity ward had the lowest cTn concentrations with results above the 99th percentile being only 0-2% of the total. As expected, the highest proportion of results >99th percentile came from Coronary Care and Intensive Care. However, substantial numbers of persons on Medical and Surgical wards, without a primary diagnosis of cardiac disease, also had cTn >99th percentile. Particularly for cTnT, there was a highly significant odds ratio predicting mortality when results above and below the 99th percentile were compared.
  
  
  CONCLUSIONS
  Significant illnesses apart from the acute coronary syndrome are important causes of a rise in cTn to above the 99th percentile, and appear to reflect the total body burden of disease. Even when the high hs-cTn concentration is not due to the acute coronary syndrome, there is a significant association with all-cause mortality.
authors: Department of Chemical Pathology, The Canberra Hospital, Canberra, ACT, 2605, Australia; Australian National University Medical School, Canberra, ACT, 2601, Australia.
authors: Julia M
authors: JM
authors: Potter
authors: Department of Chemical Pathology, The Canberra Hospital, Canberra, ACT, 2605, Australia.
authors: Aaron J
authors: AJ
authors: Simpson
authors: Department of Chemical Pathology, The Canberra Hospital, Canberra, ACT, 2605, Australia.
authors: Jennifer
authors: J
authors: Kerrigan
authors: Department of Chemical Pathology, The Canberra Hospital, Canberra, ACT, 2605, Australia; Australian National University Medical School, Canberra, ACT, 2601, Australia.
authors: Emma
authors: E
authors: Southcott
authors: Department of Chemical Pathology, The Canberra Hospital, Canberra, ACT, 2605, Australia.
authors: Marie M
authors: MM
authors: Salib
authors: Department of Chemical Pathology, The Canberra Hospital, Canberra, ACT, 2605, Australia; University of Canberra, ACT, 2601, Australia.
authors: Gus
authors: G
authors: Koerbin
authors: Department of Chemical Pathology, The Canberra Hospital, Canberra, ACT, 2605, Australia; Australian National University Medical School, Canberra, ACT, 2601, Australia. Electronic address: peter.hickman@act.gov.au.
authors: Peter E
authors: PE
authors: Hickman
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D003430:Cross-Sectional Studies; D006761:Hospitals; D006801:Humans; D010045:Outpatients; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000378:metabolism*; D020107:Troponin T / Q000378:metabolism*
chemical_list: D019210:Troponin I; D020107:Troponin T
keywords: 99th percentile; Acute coronary syndrome; Cardiac troponin; Non-cardiac illness