RT Journal Article
SR Electronic
T1 Distribution of contemporary sensitivity troponin in the emergency department and relationship to 30-day mortality: The CHARIOT-ED substudy
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 528
OP 534
DO 10.7861/clinmed.2020-0267
VO 20
IS 6
A1 Hinton, Jonathan
A1 Mariathas, Mark
A1 Gabara, Lavinia
A1 Nicholas, Zoe
A1 Allan, Rick
A1 Ramamoorthy, Sanjay
A1 Mamas, Mamas A
A1 Mahmoudi, Michael
A1 Cook, Paul
A1 Curzen, Nick
YR 2020
UL http://www.rcpjournals.org/content/20/6/528.abstract
AB Background Contemporary sensitivity troponin (cs-cTn) concentrations above the upper limit of normal (ULN) are seen in a wide range of clinical conditions and evidence is growing that suggests cs-cTn may be a biomarker of future morbidity and mortality.Objectives Our aim was to test the hypothesis that cs-cTn, measured in the emergency department, may be a biomarker for 30-day mortality, irrespective of the patient's presentation.Method In all 5,708 consecutive cases, contemporary sensitivity troponin I (cs-cTnI) was measured either as requested by the clinical team or as part of the study, in which case both the clinical team and the patient were unaware of the result. Basic demographics were available from the original study and 30-day mortality was derived from NHS Digital data.Results In patients whose cs-cTnI test was requested solely as part of the study, 30-day mortality increased with increasing cs-cTnI concentrations (0% with undetectable concentrations to 14.7% with concentrations above the ULN). Multivariable Cox regression analysis showed that log(10)cs-cTnI concentration was independently associated with 30-day mortality.Conclusion Increasing cs-cTnI concentrations are associated with higher short-term mortality as well as length of stay. As such, cs-cTnI measurements may provide useful prognostic information.