Elevated troponin in patients with acute gastrointestinal bleeding: prevalence, predictors and outcomes
Omar Kousa1, Yazan Addasi2, Akshay Machanahalli Balakrishna2
1Department of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA.
Insights
Elevated cardiac troponin (cTn) in acute gastrointestinal bleeding (AGIB) patients is common, linked to more cardiac workups and longer hospital stays, but not increased mortality.
Area of Science:
- Cardiology
- Gastroenterology
- Critical Care Medicine
Background:
- Cardiac troponin (cTn) elevation can occur in non-cardiac conditions.
- The significance of elevated cTn in acute gastrointestinal bleeding (AGIB) is not well-defined.
Purpose of the Study:
- To determine the prevalence, predictors, and mortality associated with elevated cTn in patients with AGIB.
Main Methods:
- Retrospective analysis of 172 patients admitted with AGIB who underwent cTn testing.
- Assessment of demographic, clinical factors, and outcomes including mortality.
Main Results:
- 17% of AGIB patients had abnormal cTn levels.
- Predictors included advanced age, low BMI, coronary artery disease, and chronic kidney disease.
- Elevated cTn correlated with increased cardiac consultations, procedures, and longer hospital stays, but not mortality.
Conclusions:
- Elevated cTn in AGIB patients is associated with increased cardiac investigations and healthcare utilization.
- Elevated cTn does not appear to significantly impact mortality in this cohort.
Abstract:
Background: Cardiac troponin (cTn) can also be elevated in patients with non-cardiac illnesses. The utility of elevated cTn in patients with acute gastrointestinal bleeding (AGIB) is unclear. Methods: We retrospectively identified all patients admitted with AGIB who had cTn ordered. We assessed the prevalence, predictors and mortality. Results: A total of 172 patients with AGIB were included in the study, of whom 17% had abnormal cTn. Predictors of elevated cTn were advanced age, lower BMI, coronary artery disease and chronic kidney disease. The abnormal cTn group had more cardiac consultation and procedures and longer length of stay. However, there was no difference in mortality between the two groups. Conclusion: Elevated cTn in patients with AGIB was associated with more cardiology consultation and downstream cardiac testing, greater delay to endoscopic evaluation and longer length of stay, without significantly affecting the mortality.
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