Association Between All-Cause Mortality and High-Sensitivity Cardiac Troponin Concentrations in Patients With Chest...

Area of Science:

• Cardiology
• Biomarkers
• Emergency Medicine

Background:

• Chest pain is a common emergency department presentation.
• Troponin levels are crucial biomarkers for diagnosing myocardial infarction.
• Existing troponin cutoff values may require refinement for diverse populations.

Purpose of the Study:

• To evaluate the association between varying high-sensitivity troponin I (HSTNI) levels and all-cause mortality.
• To establish novel cutoff values for HSTNI in patients presenting with chest pain.
• To compare mortality risks across different troponin level categories.

Main Methods:

• Retrospective cohort study of adult patients with chest pain (ICD-10 R07) at CAMC (June 2020-June 2021).
• Patients categorized into negative, weakly positive, and strongly positive HSTNI groups based on novel sex-specific and general cutoffs.
• Propensity score matching analysis compared mortality at 30 days and 6 months between positive and negative troponin groups, controlling for covariates.

Main Results:

• Patients with weakly positive and strongly positive troponin levels exhibited increased all-cause mortality compared to those with negative levels.
• The study identified specific novel cutoff values for HSTNI.
• Propensity score matching confirmed the association between elevated troponin and mortality risk.

Conclusions:

• Elevated troponin levels, including those previously considered weakly positive, are significantly associated with increased all-cause mortality in chest pain patients.
• The proposed novel HSTNI cutoffs may improve risk stratification.
• Further research is warranted to validate these findings and refine troponin-based clinical decision-making.