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BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2023

Open Access 01-12-2023 | Triage | Research

Myocardial injury defined as elevated high-sensitivity cardiac troponin T is associated with higher mortality in patients seeking care at emergency departments with acute dyspnea

Authors: T Wessman, A Zorlak, Per Wändell, O Melander, AC Carlsson, T Ruge

Published in: BMC Emergency Medicine | Issue 1/2023

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Abstract

Background

Elevated levels of cardiac troponin T has been observed in patients seeking care at the emergency department (ED) presenting with chest pain but without myocardial infarction (MI). The clinical importance of this observation remains, however, still unclear. Our main aim was to study the role of cardiac troponin T in patients admitted to the emergency department with acute dyspnea, a group of patients with a high cardiovascular comorbidity, but no primary acute MI.

Population and methods

Patients from the age of 18 seeking care at the ED for dyspnea, without an acute cardiac syndrome, and with a recorded assessment of high-sensitivity cardiac troponin T (hs-cTnT), were included (n = 1001). Patients were categorized into 3 groups by hs-cTnT level, i.e. <15, 15–100 and > 100 µg/l. Cox regression with Hazard Ratios (HRs) and 95% Confidence Intervals (CI) for 3-months mortality was performed, with adjustment for sex, age, respiratory frequency, saturation, CHF, renal disease, and BMI.

Results

Fully adjusted HRs (95% CI) for 3-month mortality, with hs-cTnT < 15 µg/l as reference level, showed for hs-cTnT 15–100 a HR of 3.682 (1.729–7.844), and for hs-cTnT > 100 a HR of 10.523 (4.465–24.803).

Conclusion

Elevated hs-cTnT seems to be a relevant marker of poor prognosis in patients with acute dyspnea without MI and warrants further validation and clinical testing.
Appendix
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Metadata
Title
Myocardial injury defined as elevated high-sensitivity cardiac troponin T is associated with higher mortality in patients seeking care at emergency departments with acute dyspnea
Authors
T Wessman
A Zorlak
Per Wändell
O Melander
AC Carlsson
T Ruge
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2023
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-023-00787-w

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