Inpatient Mortality and 30-Day Readmission Rates Associated with Troponin Testing in Patients without Acute...

Area of Science:

• Cardiology
• Biomarkers
• Clinical Outcomes

Background:

• Elevated troponin levels, exceeding the 99th percentile threshold for acute myocardial infarction (AMI), are frequently observed in patients without AMI.
• Differentiating between type 1 AMI and other causes of myocardial injury (type 2 AMI) is crucial for accurate diagnosis and management.

Purpose of the Study:

• To compare inpatient mortality and 30-day readmission rates in patients with troponin I (TnI) levels above and below the 99th percentile.
• To analyze these outcomes in patients diagnosed with type 1 AMI versus type 2 myocardial injury.

Main Methods:

• Retrospective analysis of 56,895 inpatient hospitalizations from January 1, 2016, to December 31, 2016.
• Evaluation of mortality and readmissions based on primary discharge diagnosis (type 1 AMI vs. type 2 AMI, including heart failure, sepsis).
• Comparison of outcomes based on troponin I levels above (≥ 0.1 ng/ml) or below the 99th percentile threshold.

Main Results:

• In-hospital mortality was significantly higher in patients who received troponin testing (5.0%) compared to those who did not (0.7%).
• Among tested patients, 26% had TnI levels above the 99th percentile (≥ 0.1 ng/ml).
• Patients with type 2 AMI and elevated TnI (≥ 0.1 ng/ml) exhibited higher inpatient mortality (11.6%) and 30-day readmission rates (16.9%) compared to type 1 AMI (3.9% and 10.7%, respectively).

Conclusions:

• Patients diagnosed with type 2 myocardial injury demonstrate significantly higher inpatient mortality and 30-day readmission rates compared to those with type 1 AMI.
• Elevated troponin levels in non-AMI conditions warrant careful consideration of underlying causes and associated risks.