Impact of troponin testing in noncardiac admissions
Rajesh Tota-Maharaj1, Bhooshan Perera, Jeffrey Murray
1From the *Department of Medicine, Danbury Hospital, Danbury, CT; †Department of Medicine, St. George's University School of Medicine, St. George, Grenada; ‡Department of Medical Education and Research, Danbury Hospital, Danbury, CT; §Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY; and ¶Department of Medicine, Columbia University, New York, NY.
Background:
There is little data to support Troponin I (TNI) use in the management of noncardiac patients. We studied the use of TNI in patients on our gastroenterology service, to determine whether there was a change in management as a result of TNI testing.
Methodology:
Patients admitted from September 2011 to June 2012 to our gastroenterology service who had TNI performed were included. Data collected included symptoms, cardiovascular risk factors, medical treatment, and testing.
Results:
Sixty-three of 295 patients had a positive TNI. The mean length of stay was significantly longer with a positive troponin (180 vs. 108 hours, P<0.001). Age, hypertension, diabetes, coronary artery disease, and chronic kidney disease were associated with a positive TNI. Cardiac consultation and echocardiography were performed in a higher proportion of TNI positive patients (P<0.0001). There were no statistically significant changes in treatment with clopidogrel, beta-blockers, angiotensin converting enzyme inhibitors, or statins between both groups.
Conclusions:
TNI testing in patients admitted to the gastroenterology service was associated with increased length of stay and echocardiography, without any change in management. This study supports adherence to national guidelines for the use of TNI, to reduce TNI testing and length of hospital stay.
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