Diagnoses and mortality in a population without acute myocardial infarction, but with elevated high-sensitive
R S Hansen1, J Revsholm1, D P Henriksen1
1Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark.
Insights
Elevated high-sensitive troponin I (hs-TnI) without acute myocardial infarction (AMI) is linked to serious conditions like pneumonia and heart failure. Careful evaluation is crucial due to high mortality rates in these patients.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Diagnostics
Background:
- Elevated cardiac troponins are a key indicator of myocardial injury.
- Acute myocardial infarction (AMI) is the primary diagnosis considered.
- Differential diagnoses for elevated troponins without AMI require further investigation.
Purpose of the Study:
- To identify differential diagnoses in patients with elevated high-sensitive troponin I (hs-TnI) but without acute myocardial infarction (AMI).
- To determine the mortality rates associated with elevated hs-TnI in the absence of AMI.
Main Methods:
- Retrospective, register-based study.
- Utilized a representative Danish population sample.
- Included individuals aged 18+ with hs-TnI ≥ 25 ng/L, excluding AMI cases.
Main Results:
- 3067 individuals without AMI but with elevated hs-TnI were analyzed.
- Most frequent discharge diagnoses included pneumonia (12.8%), aortic valve disorder (11.3%), medical observation (10.9%), and heart failure (8.9%).
- 30-day and one-year mortality rates were 15.8% and 32.0%, respectively.
Conclusions:
- Several alternative diagnoses should be considered in patients presenting with elevated hs-TnI without AMI.
- The high mortality observed underscores the critical need for thorough evaluation of these individuals, even when AMI is ruled out.
Aim:
To explore, which differential diagnoses to consider in individuals with elevated troponins without acute myocardial infarction (AMI), and the mortality for those individuals.
Methods:
Retrospective, register-based study on a representative sample of the Danish population with the following inclusion criteria: High-sensitive troponin I (hs-TnI) ⋝25 ng/L, age ⋝18 years, and exclusion of AMI.
Results:
3067 individuals without AMI but increased hs-TnI were included. Most frequent discharge diagnoses: Pneumonia (12.8%), Aortic valve disorder (11.3%), Medical observation (10.9%) and Heart failure (8.9%). The 30-days and one-year mortality was 15.8% and 32.0%, respectively.
Conclusions:
A selected number of alternative diagnoses must be considered in individuals with increased hs-TnI. Due to high mortality it is crucial to carefully evaluate these individuals despite the absence of AMI.
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