Elderly patients with non-cardiac admissions and elevated high-sensitivity troponin: the prognostic value of renal function.

Elderly High sensitivity troponin Internal medicine Non-cardiac admissions Prognosis Renal function

Journal

World journal of cardiology
ISSN: 1949-8462
Titre abrégé: World J Cardiol
Pays: United States
ID NLM: 101537090

Informations de publication

Date de publication:
26 Oct 2021
Historique:
received: 25 04 2021
revised: 27 06 2021
accepted: 08 09 2021
entrez: 10 11 2021
pubmed: 11 11 2021
medline: 11 11 2021
Statut: ppublish

Résumé

High-sensitivity cardiac troponin (hs-cTn) levels are frequently elevated in elderly patients presenting to the emergency department for non-cardiac events. However, most studies on the role of elevated hs-cTn in elderly populations have investigated the prognostic value of hs-cTn in patients with a specific diagnosis or have assessed the relationship between hs-cTn and comorbidities. To investigate the in-hospital prognosis of consecutive elderly patients admitted to the Internal Medicine Department with acute non-cardiac events and increased hs-cTnI levels. In this retrospective study, we selected patients who were aged ≥ 65 years and admitted to the Internal Medicine Department of our hospital between January 2019 and December 2019 for non-cardiac reasons. Eligible patients were those who had hs-cTnI concentrations ≥ 100 ng/L. We investigated the independent predictors of in-hospital mortality by multivariable logistic regression analysis. One hundred and forty-six patients (59% female) were selected with an age range from 65 to 100 (mean ± SD: 85.4 ± 7.61) years. The median hs-cTnI value was 284.2 ng/L. For 72 (49%) patients the diagnosis of hospitalization was an infectious disease. The overall in-hospital mortality was 32% (47 patients). Individuals who died did not have higher hs-cTnI levels compared with those who were discharged alive (median: 314.8 Myocardial injury is a malignant condition in elderly patients admitted to the hospital for non-cardiac reasons. The presence of severe renal impairment is a marker of extremely high in-hospital mortality.

Sections du résumé

BACKGROUND BACKGROUND
High-sensitivity cardiac troponin (hs-cTn) levels are frequently elevated in elderly patients presenting to the emergency department for non-cardiac events. However, most studies on the role of elevated hs-cTn in elderly populations have investigated the prognostic value of hs-cTn in patients with a specific diagnosis or have assessed the relationship between hs-cTn and comorbidities.
AIM OBJECTIVE
To investigate the in-hospital prognosis of consecutive elderly patients admitted to the Internal Medicine Department with acute non-cardiac events and increased hs-cTnI levels.
METHODS METHODS
In this retrospective study, we selected patients who were aged ≥ 65 years and admitted to the Internal Medicine Department of our hospital between January 2019 and December 2019 for non-cardiac reasons. Eligible patients were those who had hs-cTnI concentrations ≥ 100 ng/L. We investigated the independent predictors of in-hospital mortality by multivariable logistic regression analysis.
RESULTS RESULTS
One hundred and forty-six patients (59% female) were selected with an age range from 65 to 100 (mean ± SD: 85.4 ± 7.61) years. The median hs-cTnI value was 284.2 ng/L. For 72 (49%) patients the diagnosis of hospitalization was an infectious disease. The overall in-hospital mortality was 32% (47 patients). Individuals who died did not have higher hs-cTnI levels compared with those who were discharged alive (median: 314.8
CONCLUSION CONCLUSIONS
Myocardial injury is a malignant condition in elderly patients admitted to the hospital for non-cardiac reasons. The presence of severe renal impairment is a marker of extremely high in-hospital mortality.

Identifiants

pubmed: 34754401
doi: 10.4330/wjc.v13.i10.566
pmc: PMC8554362
doi:

Types de publication

Journal Article

Langues

eng

Pagination

566-573

Informations de copyright

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: None of the authors has any conflicts of interest.

Références

J Am Coll Cardiol. 2020 Aug 4;76(5):533-546
pubmed: 32517963
Circulation. 2018 Jan 30;137(5):425-435
pubmed: 28978551
Respirology. 2017 Jul;22(5):1000-1006
pubmed: 28221010
J Educ Eval Health Prof. 2013 Nov 30;10:12
pubmed: 24324853
Clin Chim Acta. 2019 Jun;493:156-161
pubmed: 30826369
Clin Interv Aging. 2018 Jun 06;13:1091-1098
pubmed: 29922047
Clin Chem. 2013 Jul;59(7):1068-73
pubmed: 23462029
Clin Chem. 2017 Jan;63(1):59-65
pubmed: 27811207
Circ Cardiovasc Qual Outcomes. 2018 Feb;11(2):e004040
pubmed: 29378734
Arch Gerontol Geriatr. 2016 Jul-Aug;65:111-5
pubmed: 27017416
Diabetes Care. 2020 Jun;43(6):1200-1208
pubmed: 32161049
BMJ. 2019 Mar 13;364:l729
pubmed: 30867154
Eur Heart J. 2016 Aug 07;37(30):2428-37
pubmed: 27174290
Acad Emerg Med. 2020 Jan;27(1):6-14
pubmed: 31854117
Eur Heart J. 2012 Sep;33(18):2252-7
pubmed: 22723599
Int J Cardiol Heart Vasc. 2020 Sep 09;31:100629
pubmed: 32964099
Heart. 2020 Feb;106(4):253-255
pubmed: 31672780
J Am Soc Nephrol. 2005 Mar;16(3):763-73
pubmed: 15659562
J Am Coll Cardiol. 2013 May 7;61(18):1906-13
pubmed: 23500239
Heart. 2020 Feb;106(4):251-252
pubmed: 31672777
BMJ. 2019 Nov 20;367:l6055
pubmed: 31748235

Auteurs

Ioanna Samara (I)

Second Department of Cardiology, University Hospital of Ioannina, Ioannina 45110, Greece.

Stavroula Tsiara (S)

Second Department of Internal Medicine, University Hospital of Ioannina, Ioannina 45110, Greece.

Michail I Papafaklis (MI)

Second Department of Cardiology, University Hospital of Ioannina, Ioannina 45110, Greece.

Konstantinos Pappas (K)

Second Department of Cardiology, University Hospital of Ioannina, Ioannina 45110, Greece.

Georgios Kolios (G)

Laboratory of Biochemistry, University Hospital of Ioannina, Ioannina 45110, Greece.

Nikolaos Vryzas (N)

Second Department of Cardiology, University Hospital of Ioannina, Ioannina 45110, Greece.

Lampros K Michalis (LK)

Second Department of Cardiology, University Hospital of Ioannina, Ioannina 45110, Greece.

Eleni T Bairaktari (ET)

Laboratory of Clinical Chemistry, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina 45110, Greece.

Christos S Katsouras (CS)

Second Department of Cardiology, University Hospital of Ioannina, Ioannina 45110, Greece. cskats@yahoo.com.

Classifications MeSH