Prognostic implications of troponin I elevation in emergency department patients with tachyarrhythmia.
arrhythmia
cardiac troponin
emergency department
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
09
01
2019
revised:
06
03
2019
accepted:
14
03
2019
pubmed:
22
3
2019
medline:
19
12
2019
entrez:
22
3
2019
Statut:
ppublish
Résumé
Tachyarrhythmias are very common in emergency medicine, and little is known about the long-term prognostic implications of troponin I levels in these patients. This study aimed to investigate the correlation of cardiac troponin I (cTnI) levels and long-term prognosis in patients admitted to the emergency department (ED) with a primary diagnosis of tachyarrhythmia. A retrospective cohort study was conducted between January 2012 and December 2013, enrolling patients admitted to the ED with a primary diagnosis of tachyarrhythmia and having documented cTnI measurements. Clinical characteristics and 5-year all-cause mortality were analyzed. Of a total of 222 subjects with a primary diagnosis of tachyarrhythmia, 73 patients had elevated levels of cTnI (32.9%). Patients with elevated cTnI levels were older and presented significantly more cardiovascular risk factors. At the 5-year follow-up, mortality was higher among patients with elevated cTnI levels (log-rank test P < 0.001). In the multivariable Cox regression analysis, elevated cTnI was an independent predictor of all-cause death (hazard ratio, 1.95, 95% confidence interval: 1.08-3.50, P = 0.026), in addition to age and prior heart failure. Patients admitted to the ED with a primary diagnosis of tachyarrhythmia and high cTnI levels have higher long-term mortality rates than patients with low cTnI levels. cTnI is thus a biomarker with predictive capacity for mortality in late follow-up, conferring utility in the risk stratification of this population.
Sections du résumé
BACKGROUND
BACKGROUND
Tachyarrhythmias are very common in emergency medicine, and little is known about the long-term prognostic implications of troponin I levels in these patients.
HYPOTHESIS
OBJECTIVE
This study aimed to investigate the correlation of cardiac troponin I (cTnI) levels and long-term prognosis in patients admitted to the emergency department (ED) with a primary diagnosis of tachyarrhythmia.
METHODS
METHODS
A retrospective cohort study was conducted between January 2012 and December 2013, enrolling patients admitted to the ED with a primary diagnosis of tachyarrhythmia and having documented cTnI measurements. Clinical characteristics and 5-year all-cause mortality were analyzed.
RESULTS
RESULTS
Of a total of 222 subjects with a primary diagnosis of tachyarrhythmia, 73 patients had elevated levels of cTnI (32.9%). Patients with elevated cTnI levels were older and presented significantly more cardiovascular risk factors. At the 5-year follow-up, mortality was higher among patients with elevated cTnI levels (log-rank test P < 0.001). In the multivariable Cox regression analysis, elevated cTnI was an independent predictor of all-cause death (hazard ratio, 1.95, 95% confidence interval: 1.08-3.50, P = 0.026), in addition to age and prior heart failure.
CONCLUSION
CONCLUSIONS
Patients admitted to the ED with a primary diagnosis of tachyarrhythmia and high cTnI levels have higher long-term mortality rates than patients with low cTnI levels. cTnI is thus a biomarker with predictive capacity for mortality in late follow-up, conferring utility in the risk stratification of this population.
Identifiants
pubmed: 30895632
doi: 10.1002/clc.23175
pmc: PMC6523000
doi:
Substances chimiques
Biomarkers
0
Troponin I
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
546-552Informations de copyright
© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
Références
Clin Cardiol. 2019 May;42(5):546-552
pubmed: 30895632
Eur Heart J. 2010 Aug;31(15):1836-44
pubmed: 20584774
Circulation. 2012 Oct 16;126(16):2020-35
pubmed: 22923432
Nat Rev Cardiol. 2013 Sep;10(9):508-18
pubmed: 23817188
Int J Cardiol. 2016 Aug;217 Suppl:S37-43
pubmed: 27381858
Am J Med. 2016 Apr;129(4):446.e5-446.e21
pubmed: 26593739
Can J Cardiol. 2011 Jan-Feb;27(1):105-9
pubmed: 21329868
Tex Heart Inst J. 2017 Oct 1;44(5):306-311
pubmed: 29259499
J Crit Care. 2010 Jun;25(2):270-5
pubmed: 20149590
Rev Esp Cardiol (Engl Ed). 2015 Jun;68(6):469-76
pubmed: 25800165
Emergencias. 2018 Abr;30(2):77-83
pubmed: 29547229
Heart. 2017 Apr;103(8):616-622
pubmed: 27742797
Clin Chem. 2008 Apr;54(4):723-8
pubmed: 18238833
JAMA. 2000 Jun 28;283(24):3223-9
pubmed: 10866870
Cardiology. 2006;106(1):10-3
pubmed: 16601327
Int J Cardiol. 2005 Jul 20;102(3):521-2
pubmed: 16004900
Biomarkers. 2017 May - Jun;22(3-4):337-344
pubmed: 27879165
Acute Card Care. 2012 Dec;14(4):131-7
pubmed: 23215748
JAMA. 2012 Feb 22;307(8):813-22
pubmed: 22357832
Eur Heart J. 2009 Jun;30(11):1411-20
pubmed: 19269986
Swiss Med Wkly. 2003 Aug 9;133(31-32):439-41
pubmed: 14562187
Am J Med. 2013 Sep;126(9):789-97
pubmed: 23856021
Int J Cardiol. 2006 Nov 18;113(3):E109-10
pubmed: 17010458
Am J Med. 2014 Apr;127(4):295-302
pubmed: 24457000
Emergencias. 2016 Oct;28(5):298-304
pubmed: 29106099
Cardiovasc Revasc Med. 2018 Jul;19(5 Pt A):487-492
pubmed: 29352700
Ann Intern Med. 2005 May 3;142(9):786-91
pubmed: 15867411
Medicine (Baltimore). 2010 May;89(3):141-148
pubmed: 20453600
Acta Physiol Scand. 2000 Jun;169(2):95-102
pubmed: 10848639
Int J Cardiol. 2018 May 15;259:186-191
pubmed: 29477263
J Am Coll Cardiol. 1998 Jan;31(1):150-7
pubmed: 9426034