Prognostic implications of troponin I elevation in emergency department patients with tachyarrhythmia. Issue 5 (26th March 2019)

• Record Type: Journal Article
• Authors: González‐Del‐Hoyo, Maribel; Cediel, Germán; Carrasquer, Anna; Bonet, Gil; Vásquez‐Nuñez, Karla; Boqué, Carme; Alí, Samuel; Bardají, Alfredo
• Is Part Of: Clinical cardiology. Volume 42:Issue 5(2019)
• Page Start: 546
• Page End: 552
• Publication Date: 2019-03-26
• Subjects: arrhythmia -- cardiac troponin -- emergency department; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.23175
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : 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: 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: 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: 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: 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.