High-sensitivity cardiac troponin T levels in the emergency department in patients with chest pain but no myocardial infarction

详细信息    查看全文

• 作者：Axel C Carlsson^a ; ^b ; Nadia Bandstein^c ; ^d ; Andreas Roos^c ; ^d ; Ola Hammarsten^e ; Martin J Holzmann^c ; ^d ; ^{martin.holzmann@karolinska.se}
• 关键词：High-sensitivity cardiac troponin T ; Emergency department ; Normal level ; No myocardial infarction
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：253-259
• 全文大小：468 K
• 卷排序：228

文摘

High-sensitivity cardiac troponin T (hs-cTnT) was recently introduced into clinical practice. The increased sensitivity has decreased the specificity. We aimed to determine the predictors for and prevalence of hs-cTnT levels above the 99th percentile in a stable population of patients without myocardial infarction (MI) who sought medical attention for chest pain in the emergency department.MethodsWe included 11,847 patients with chest pain and at least one hs-cTnT measurement during 2011 and 2012. Patients with any acute reasons for an elevated hs-cTnT level were excluded. We used logistic regression to calculate adjusted odds ratios with 95% confidence intervals for the association between patient characteristics and hs-cTnT levels of > 14 ng/L. We also determined 50th, 75th, 97.5th, and 99th percentile values of hs-cTnT levels in relation to age, sex, estimated glomerular filtration rate (eGFR), and presence or absence of comorbidities.ResultsIn total, 1360 (11%) patients had hs-cTnT levels of > 14 ng/L. Men had higher troponin levels than women, and older patients had higher levels than younger patients. The strongest predictor of an elevated troponin level was a reduced eGFR. The 99th percentile for hs-cTnT among all men and among women < 50 years of age with normal renal function was 20 and 12 ng/L, respectively; this level increased to 44 and 36 ng/L, respectively, at the age of 70–79 years.ConclusionsA hs-cTnT level above the 99th percentile in patients with chest pain but no MI is common and is related to sex, age, and eGFR.