Association between cardiac troponin testing at scheduled admission and mortality in patients with comorbidities
Ah Ran Oh1,2, Seung-Hwa Lee3,4, Jungchan Park1,5
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Measuring cardiac troponin I (cTnI) upon admission for patients with comorbidities is associated with reduced one-year mortality. This cardiac biomarker testing may improve patient outcomes and guide timely cardiac evaluations.
Area of Science:
- Cardiology
- Biomarker Research
- Clinical Outcomes
Background:
- Cardiac troponin I (cTnI) is a key biomarker for myocardial infarction detection.
- Emerging evidence suggests cTnI has prognostic value in chronic diseases.
- The study investigates cTnI's utility in patients with comorbidities upon scheduled admission.
Purpose of the Study:
- To evaluate the clinical usefulness of cardiac troponin I (cTnI) testing.
- To assess the impact of cTnI measurement at scheduled admission on patient outcomes.
- To determine if cTnI testing influences mortality rates in patients with comorbidities.
Main Methods:
- Retrospective analysis of 50,119 patients admitted from April 2010 to December 2018.
- Patients divided into groups based on cTnI measurement at admission (n=6,145) versus no measurement (n=43,974).
- Primary endpoint: one-year mortality rate; secondary endpoints: 30-day and in-hospital mortality. Propensity score matching used for robust comparison.
Main Results:
- One-year mortality was significantly lower in the cTnI group (3.8%) compared to the no-cTnI group (5.9%) [HR=0.78, P<0.001].
- This survival benefit persisted in propensity score-matched pairs (3.9% vs 5.3%, HR=0.77, P=0.002).
- Patients with cTnI testing received more frequent cardiac evaluations and therapy.
Conclusions:
- Cardiac troponin I measurement at scheduled admission may reduce one-year mortality in patients with comorbidities.
- The findings suggest cTnI testing can impact clinical management and outcomes.
- Further research is recommended to validate these prognostic findings.
Background:
Cardiac troponin I (cTnI) is a gold-standard biomarker for detecting myocardial infarction. Recently, the prognostic role of cTnI was reported for stable coronary artery disease and other chronic diseases. This study aimed to evaluate the usefulness of cTnI testing at scheduled admission of patients with comorbidities.
Methods:
We retrospectively enrolled patients with comorbidities who were admitted through the outpatient clinic from April 2010 to December 2018. The enrolled patients were divided into two groups depending on whether cTnI was measured at admission. The primary endpoint was the mortality rate at one year after admission. Secondary endpoints included 30-day and in-hospital mortality rates.
Results:
A population of 50,119 patients was divided into two groups, with 43,974 (87.8%) patients included in the no cTnI group and 6,145 (12.2%) patients included in the cTnI group. The multivariable analysis showed a reduction of mortality at one year in the cTnI group [5.9% vs. 3.8%, hazard ratio (HR) =0.78; 95% confidence interval (CI): 0.68-0.89; P<0.001]. Among 5,882 propensity score-matched pairs, this trend persisted, and the mortality rate was significantly lower in the cTnI group (5.3% vs. 3.9%, HR =0.77; 95% CI: 0.65-0.91; P=0.002). Patients with cTnI measurements taken at admission underwent cardiac evaluation and therapy more frequently.
Conclusions:
The measurement of cTnI at scheduled admission may affect the mortality during one year of follow-up. Further studies are needed to validate our results.
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