Association of mild transient elevation of troponin I levels with increased mortality and major cardiovascular events in the general patient population

Arch Pathol Lab Med. 2005 Apr;129(4):474-80. doi: 10.1043/1543-2165(2005)129<474:AOMTEO>2.0.CO;2.

Abstract

Context: The prognostic value of mild elevation of cardiac-specific troponin I (cTnI) levels is poorly defined, which can make interpretation of such an elevation difficult.

Objective: To study the prognostic value of transient mild elevation of cTnI levels in the hospitalized patient population.

Design: We performed a case-control study that compared the outcome of patients hospitalized for any cause with at least 2 subsequent transient cTnI measurements of 0.1 ng/mL or higher and less than 1.5 ng/mL with matched controls with cTnI levels less than 0.1 ng/mL. A cohort of 118 patients (mean +/- SD age, 67.4 +/- 14.0 years; 35.6% men) was followed up for an average +/- SD of 11.9 +/- 7.9 months. Seventy-one cases were matched with 37 controls in terms of demographics, coronary artery disease risk factors, and reason for admission. End points were all-cause mortality and major cardiovascular end points, including cardiovascular mortality, myocardial infarction, and revascularization.

Results: The total event rate was significantly increased in the case group compared with the control group at 12, 6, and 3 months (62.0% vs 24.3%, 59.2% vs 16.2%, and 47.9% vs 5.4%, respectively; P < .001). At 12, 6, and 3 months, the cases had a significant increase in all-cause mortality (43.7% vs 16.2%, 40.8% vs 8.1%, and 33.8% vs 0.0%, respectively; P = .005) and major cardiovascular end points (26.8% vs 8.1%, 26.8% vs 8.1%, and 21.1% vs 5.4%, respectively; P = .02) compared with controls.

Conclusion: Transient mild elevation of cTnI levels in hospitalized patients is associated with an increase in all-cause mortality and major cardiovascular complications. Such elevations of cTnI levels can be considered a marker for both all-cause and cardiovascular morbidity and mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Case-Control Studies
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Morbidity
  • Mortality*
  • Prognosis
  • Troponin I / blood*

Substances

  • Troponin I