Cardiac troponin-I as a predictor of mortality in patients with first episode acute atrial fibrillation.
BACKGROUND
Recent-onset atrial fibrillation (AF) is a frequent cause for presentation to the emergency department. Recent studies proposed that the addition of biomarker information might improve the prediction of clinical outcomes by enabling identification of patients at high risk.


OBJECTIVE
We aimed to examine the role of cardiac troponin I as a predictor of clinical outcome in patients with first episode acute AF.


METHODS
Patients, 18 years or older, presenting to our hospital with a primary diagnosis of first episode acute AF were included in this retrospective study.


METHODS
The association between elevated cTnI with mortality or the composite endpoint (mortality, stroke or heart failure) was examined in a univariate Cox regression model.


RESULTS
Of the 274 study patients, 111 had elevated cTnI levels (41%). Increased cTnI was associated with older age, history of myocardial infarction, higher creatinine levels and higher heart rate (All P < 0.01). Elevated cTn was associated with an adjusted hazard ratio of 1.86 [95% confidence interval (CI) 1.17-2.96; P = 0.009] for mortality and 1.89 (95% CI 1.27-2.84; P = 0.002) for the combined endpoint.


CONCLUSIONS
Elevated cardiac Troponin I is a significant predictor of mortality and a composite endpoint of mortality, stroke or heart failure in patients presenting with first episode acute AF.
Department of Internal Medicine "H", Rambam Health Care Campus, Haifa, Israel.|Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
M E
ME
Naffaa
Department of Internal Medicine "B".
R
R
Nasser
Division of General Surgery.
E
E
Manassa
Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
M
M
Younis
Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.|Department of Internal Medicine "B".
Z S
ZS
Azzam
Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.|Division of Cardiology, Rambam Health Care Campus, Haifa, Israel.
D
D
Aronson
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006339:Heart Rate; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D020521:Stroke / Q000401:mortality*; D016019:Survival Analysis; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D003404:Creatinine