Non-coronary predictors of elevated high-sensitive cardiac troponin T (hs-cTnT) levels in an unselected emergency patient cohort

• Verfasst von: Berger, Manfred [VerfasserIn]
• Verfasst von: Lehmann, Ralf [VerfasserIn]
• Titel: Non-coronary predictors of elevated high-sensitive cardiac troponin T (hs-cTnT) levels in an unselected emergency patient cohort
• Verf.angabe: Manfred Berger, Meryem Emir, Tanja Brünnler, Felix Rockmann, Ralf Lehmann
• E-Jahr: 2018
• Jahr: 17 July 2018
• Umfang: 7 S.
• Fussnoten: Gesehen am 11.03.2021
• Titel Quelle: Enthalten in: Clinical cardiology
• Ort Quelle: Weinheim [u.a.] : Wiley, 1978
• Jahr Quelle: 2018
• Band/Heft Quelle: 41(2018), 8, Seite 1055-1061
• ISSN Quelle: 1932-8737
• DOI: doi:10.1002/clc.23026
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: acute coronary syndrome
• Sach-SW: atrial fibrillation
• Sach-SW: cardiac troponin T
• Sach-SW: emergency patient cohort
• Sach-SW: hypertension
• Sach-SW: predictors
• K10plus-PPN: 1751134229

Abstract

Background Aim of this study was to evaluate the predictors of hs-cTnT in a non-ACS patient cohort admitted to the emergency department. Hypothesis Atrial fibrillation and hypertension may not always be sufficient for elevation for hs-cTnT. Methods We performed a retrospective, single center study encompassing in total 1003 patients. Individuals were retrospectively divided in ACS- and non-ACS patients by two independent investigators reviewing the medical records. In order to identify predictors of hs-cTnT elevation hazard ratios were calculated for age, gender, vital signs, cardiovascular risk factors, LVEF, serum levels of CRP, hemoglobin, and creatinine. Elevation of hs-cTnT was defined by exceeding 14 ng/L (upper reference limit [URL]). Results About 987 patients were included while 25 patients were excluded because of missing data. 307 patients (31.4%) met the current guideline requirements of diagnosing an ACS, whereas 671 patients (68.6%) were hospitalized with excluded ACS. In the multivariate analysis age, anemia, CRP, creatinine, and reduced systolic left ventricular ejection fraction were independent predictors of elevated troponin T levels in the non-ACS group. However, hypertensive systolic blood pressure, atrial fibrillation and tachycardia were not predictive for Troponin T elevation in non-ACS patients in this multivariate analysis. Conclusions In an unselected, non-ACS patient cohort age, chronic renal failure, inflammatory state, and reduced left ventricular systolic function were associated with hs-cTnT levels above the upper reference limit. Rather, often supposed predictors as atrial fibrillation, hypertension, and tachycardia cannot sufficiently explain increased hs-cTnT in our study. Hence, further studies are needed to assess whether isolated hypertension, tachycardia, or atrial fibrillation sufficiently explain elevated hs-cTnT.