Relation of High-Sensitivity Troponin to 1 Year Mortality in 20,000 Consecutive Hospital Patients Undergoing a Blood...

Area of Science:

• Cardiology
• Clinical Chemistry
• Epidemiology

Background:

• The CHARIOT study previously enrolled 20,000 patients.
• High sensitivity troponin I (hs-cTnI) is a biomarker for cardiac injury.
• The role of hs-cTnI in unselected hospital populations requires further investigation.

Purpose of the Study:

• To assess the association between hs-cTnI concentration and 1-year mortality.
• To evaluate hs-cTnI as a predictor of mortality in a broad hospital patient cohort.
• To analyze hs-cTnI levels measured irrespective of clinical indication.

Main Methods:

• Observational study analyzing 1-year outcomes from the CHARIOT cohort.
• hs-cTnI concentrations were measured in 20,000 consecutive in- and out-patients.
• Multivariable Cox regression analysis was used to determine associations with 1-year mortality.

Main Results:

• Overall 1-year mortality was 8.9% (1782 patients).
• Elevated hs-cTnI above the upper limit of normal was independently associated with increased mortality hazard (HR 2.23).
• Log-transformed hs-cTnI concentration also showed independent association with 1-year mortality hazard (HR 1.77).

Conclusions:

• hs-cTnI concentration is associated with 1-year mortality in a large, unselected hospital population.
• This association persisted even when hs-cTnI testing was not clinically indicated.
• hs-cTnI may serve as a valuable prognostic biomarker across diverse hospital patients.