Incidentally raised cardiac Troponin I has a worse prognosis in older patients compared to those with normal cardiac Troponin I and patients with Acute Coronary Syndrome:A Cohort Study

Mannu, Gurdeep Singh, Honney, Katie, Spooner, Robert, Clark, Allan B, Bettencourt-Silva, Joao H, Zaman, M Justin S, Loke, Yoon K and Myint, Phyo K (2016) Incidentally raised cardiac Troponin I has a worse prognosis in older patients compared to those with normal cardiac Troponin I and patients with Acute Coronary Syndrome:A Cohort Study. Gerontology, 32 (6). pp. 581-587. ISSN 0304-324X

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Abstract

BACKGROUND: Incidentally elevated cardiac troponin I (cTnI) levels are common in acutely unwell older patients. However, little is known about how this impacts on the prognosis of these patients. OBJECTIVE: We aimed to investigate whether incidentally elevated cTnI levels (group 1) are associated with poorer outcome when compared to age- and sex-matched patients without an elevated cTnI level (group 2), and to patients diagnosed with acute coronary syndrome (group 3). PATIENTS AND METHODS: This prospective, matched cohort study placed patients ≥75 years old who were admitted to a University teaching hospital into groups 1-3, based on the cTnI levels and underlying diagnosis. Outcomes were compared between the groups using mixed-effects regression models and adjusted for renal function and C-reactive protein. All-cause mortality at discharge, at 1 month and 3 months, alongside the length of hospital stay (LOS), were recorded. RESULTS: In total, 315 patients were included, with 105 patients in each of the 3 groups. The mean age was 84.8 ± 5.5 years, with 41.9% males. All patients were followed up for 3 months. The percent all-cause mortality at discharge and the LOS for groups 1, 2 and 3 were 12.4, 3.8 and 8.6% and 11.2, 8.5 and 7.7 days, respectively. Group 1 had significantly increased mortality at 3 months [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.12-6.96; p = 0.040] and LOS (OR 1.39, 95% CI 1.08-1.79; p = 0.008) compared to group 2 and did not differ significantly when compared to 3-month mortality (OR 2.39, 95% CI 0.91-6.29; p = 0.079) or LOS (OR 1.26, 95% CI 0.96-1.66; p = 0.097) in group 3. CONCLUSION: There is a significant association between an incidental rise in cTnI level with mortality and LOS in older patients. Further research is required to evaluate whether a more systematic management of these patients would improve the prognosis.

Item Type: Article
Additional Information: © 2016 S. Karger AG, Basel.
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 29 Apr 2016 23:05
Last Modified: 24 Jul 2019 22:13
URI: https://ueaeprints.uea.ac.uk/id/eprint/58520
DOI: 10.1159/000444083

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