Prevalence, characteristics and outcomes of people aged 65 years and over with an incidental rise in cardiac troponin I: An observational prospective cohort study

Phyo K Myint, Muna Al-Jawad, Sanoj M Chacko, Gavin S Chu, Sarah L Vowler, Helen M May

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND: Cardiac troponin I (cTnI) is a sensitive and specific marker of acute cardiac damage. We examined the prevalence, characteristics and outcome of incidental cTnI rises in older patients.

METHODS: One hundred and eighty-seven consecutive patients aged 65 years or over with a raised cTnI on admission at least 8 h after symptom onset were categorised into: (1) ST-elevation myocardial infarction, (2) other acute coronary syndromes (ACS), (3) other recognised non-ACS causes of cTnI rise and (4) non-ACS with no other identifiable cause (an incidental finding). The number of readmissions and deaths for each group was measured at 30 and 90 days.

RESULTS: Age range = 65-98 years. Male = 55.6%. Fifty-four percent had a raised cTnI due to non-ACS illnesses, whilst in 18% it was an incidental finding. The latter group was relatively older and had a significantly lower degree of cTnI rise (U = 1718.5, p = 0.002), but a higher readmission and mortality rate compared to the other groups (categories 1-3) for both follow-up periods.

CONCLUSIONS: Incidental cTnI rise is common in older patients and is associated with a poorer prognosis compared to ACS or a recognised non-ACS condition. Future research should attempt to evaluate the significance of such incidental rises in elderly patients.

Original languageEnglish
Pages (from-to)62-67
Number of pages6
JournalCardiology
Volume110
Issue number1
DOIs
Publication statusPublished - Apr 2008

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Troponin I
Cohort Studies
Prospective Studies
Incidental Findings
Acute Coronary Syndrome
Mortality

Keywords

  • acute coronary syndrome
  • age distribution
  • aged
  • aged, 80 and over
  • biomarkers
  • cohort studies
  • electrocardiography
  • emergency service, hospital
  • female
  • follow-up studies
  • humans
  • incidental findings
  • male
  • observation
  • prevalence
  • probability
  • prospective studies
  • sensitivity and specificity
  • severity of illness index
  • sex distribution
  • statistics, nonparametric
  • time factors
  • troponin I

Cite this

Prevalence, characteristics and outcomes of people aged 65 years and over with an incidental rise in cardiac troponin I : An observational prospective cohort study. / Myint, Phyo K; Al-Jawad, Muna; Chacko, Sanoj M; Chu, Gavin S; Vowler, Sarah L; May, Helen M.

In: Cardiology, Vol. 110, No. 1, 04.2008, p. 62-67.

Research output: Contribution to journalArticle

Myint, Phyo K ; Al-Jawad, Muna ; Chacko, Sanoj M ; Chu, Gavin S ; Vowler, Sarah L ; May, Helen M. / Prevalence, characteristics and outcomes of people aged 65 years and over with an incidental rise in cardiac troponin I : An observational prospective cohort study. In: Cardiology. 2008 ; Vol. 110, No. 1. pp. 62-67.
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abstract = "BACKGROUND: Cardiac troponin I (cTnI) is a sensitive and specific marker of acute cardiac damage. We examined the prevalence, characteristics and outcome of incidental cTnI rises in older patients.METHODS: One hundred and eighty-seven consecutive patients aged 65 years or over with a raised cTnI on admission at least 8 h after symptom onset were categorised into: (1) ST-elevation myocardial infarction, (2) other acute coronary syndromes (ACS), (3) other recognised non-ACS causes of cTnI rise and (4) non-ACS with no other identifiable cause (an incidental finding). The number of readmissions and deaths for each group was measured at 30 and 90 days.RESULTS: Age range = 65-98 years. Male = 55.6{\%}. Fifty-four percent had a raised cTnI due to non-ACS illnesses, whilst in 18{\%} it was an incidental finding. The latter group was relatively older and had a significantly lower degree of cTnI rise (U = 1718.5, p = 0.002), but a higher readmission and mortality rate compared to the other groups (categories 1-3) for both follow-up periods.CONCLUSIONS: Incidental cTnI rise is common in older patients and is associated with a poorer prognosis compared to ACS or a recognised non-ACS condition. Future research should attempt to evaluate the significance of such incidental rises in elderly patients.",
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T1 - Prevalence, characteristics and outcomes of people aged 65 years and over with an incidental rise in cardiac troponin I

T2 - An observational prospective cohort study

AU - Myint, Phyo K

AU - Al-Jawad, Muna

AU - Chacko, Sanoj M

AU - Chu, Gavin S

AU - Vowler, Sarah L

AU - May, Helen M

PY - 2008/4

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N2 - BACKGROUND: Cardiac troponin I (cTnI) is a sensitive and specific marker of acute cardiac damage. We examined the prevalence, characteristics and outcome of incidental cTnI rises in older patients.METHODS: One hundred and eighty-seven consecutive patients aged 65 years or over with a raised cTnI on admission at least 8 h after symptom onset were categorised into: (1) ST-elevation myocardial infarction, (2) other acute coronary syndromes (ACS), (3) other recognised non-ACS causes of cTnI rise and (4) non-ACS with no other identifiable cause (an incidental finding). The number of readmissions and deaths for each group was measured at 30 and 90 days.RESULTS: Age range = 65-98 years. Male = 55.6%. Fifty-four percent had a raised cTnI due to non-ACS illnesses, whilst in 18% it was an incidental finding. The latter group was relatively older and had a significantly lower degree of cTnI rise (U = 1718.5, p = 0.002), but a higher readmission and mortality rate compared to the other groups (categories 1-3) for both follow-up periods.CONCLUSIONS: Incidental cTnI rise is common in older patients and is associated with a poorer prognosis compared to ACS or a recognised non-ACS condition. Future research should attempt to evaluate the significance of such incidental rises in elderly patients.

AB - BACKGROUND: Cardiac troponin I (cTnI) is a sensitive and specific marker of acute cardiac damage. We examined the prevalence, characteristics and outcome of incidental cTnI rises in older patients.METHODS: One hundred and eighty-seven consecutive patients aged 65 years or over with a raised cTnI on admission at least 8 h after symptom onset were categorised into: (1) ST-elevation myocardial infarction, (2) other acute coronary syndromes (ACS), (3) other recognised non-ACS causes of cTnI rise and (4) non-ACS with no other identifiable cause (an incidental finding). The number of readmissions and deaths for each group was measured at 30 and 90 days.RESULTS: Age range = 65-98 years. Male = 55.6%. Fifty-four percent had a raised cTnI due to non-ACS illnesses, whilst in 18% it was an incidental finding. The latter group was relatively older and had a significantly lower degree of cTnI rise (U = 1718.5, p = 0.002), but a higher readmission and mortality rate compared to the other groups (categories 1-3) for both follow-up periods.CONCLUSIONS: Incidental cTnI rise is common in older patients and is associated with a poorer prognosis compared to ACS or a recognised non-ACS condition. Future research should attempt to evaluate the significance of such incidental rises in elderly patients.

KW - acute coronary syndrome

KW - age distribution

KW - aged

KW - aged, 80 and over

KW - biomarkers

KW - cohort studies

KW - electrocardiography

KW - emergency service, hospital

KW - female

KW - follow-up studies

KW - humans

KW - incidental findings

KW - male

KW - observation

KW - prevalence

KW - probability

KW - prospective studies

KW - sensitivity and specificity

KW - severity of illness index

KW - sex distribution

KW - statistics, nonparametric

KW - time factors

KW - troponin I

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DO - 10.1159/000109408

M3 - Article

C2 - 17934271

VL - 110

SP - 62

EP - 67

JO - Cardiology

JF - Cardiology

SN - 0008-6312

IS - 1

ER -