High troponin levels elevate risk for all-cause mortality, even if CVD absent
Key takeaways:
- High levels of cardiac troponin I were linked to all-cause mortality after slightly more than 2 years.
- The relationship existed even in patients with no signs of heart disease.
In a large hospital population, most of whom did not have an indication for troponin testing, high levels of cardiac troponin were associated with elevated risk for all-cause mortality, researchers reported.
“The aim of this study was to assess the relationship between medium-term mortality and cardiac troponin concentration in a large consecutive hospital population, regardless of whether there was a clinical indication for performing the test,” Nick Curzen, BM, PhD, FRCP, professor of interventional cardiology at the University of Southampton, U.K., and interventional cardiologist at University Hospital Southampton, and colleagues wrote in Heart.
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Curzen and colleagues analyzed 20,000 consecutive unselected patients (47% outpatient; 25% inpatient; 28% emergency care) who had a blood test for any reason (47% men); as part of the study, all patients had high-sensitivity cardiac troponin I measured. Among the cohort, 91.4% did not have a clinical indication for cardiac troponin I testing. Overall, 5.4% of patients had a concentration of cardiac troponin I above the upper limit of normal.
At a median follow-up of 809 days, 14.1% of patients died, according to the researchers.
If the concentration of cardiac troponin I was above the upper limit of normal, patients were more likely to die of any cause during follow-up than if it was not (45.3% vs. 12.3%; log-rank P < .001), Curzen and colleagues wrote.
In a multivariable analysis adjusting for age, sex, hospital location and kidney disease, log10 cardiac troponin I concentration was independently associated with all-cause mortality (HR = 1.76; 95% CI, 1.65-1.88).
Excluding patients who died within 30 days of testing did not change the results.
The most common cause of death was cancer (46%), and 13% of deaths were from CVD.
“These findings suggest that a snapshot cardiac troponin in a hospital population may represent a biomarker of overall medium-term mortality,” Curzen and colleagues wrote.
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