Determinants of High-Sensitivity Troponin T Among Patients with a Noncardiac Cause of Chest Pain
American Journal of Medicine,  Clinical Article

Irfan A et al. - Among the known covariates, age and not renal dysfunction is the most important determinant of high-sensitivity cardiac troponin T. Because known cardiac and noncardiac factors, including renal dysfunction, explain less than 50% of high-sensitivity cardiac troponin T levels among patients with a noncardiac cause of chest pain, unknown or underestimated cardiac involvement during the acute presenting condition seems to be the major cause of elevated high-sensitivity cardiac troponin T.

Methods
  • In an observational international multicenter study, the authors enrolled consecutive patients presenting with acute chest pain to the emergency department.
  • Of 1181 patients enrolled, 572 were adjudicated by 2 independent cardiologists to have a noncardiac cause of chest pain.
  • Multiple linear regression analyses were used to determine the important predictors of log-transformed high-sensitivity cardiac troponin T.
  • Kaplan-Meier curve was used to assess the prognostic significance of high-sensitivity cardiac troponin T>0.014 μg/L (99th percentile).

Results
  • A total of 88 patients (15%) had high-sensitivity cardiac troponin T>0.014 μg/L.
  • Less than 50% of cardiac troponins could be explained by known cardiac or noncardiac diseases.
  • In decreasing order of importance, age, estimated glomerular filtration rate, hypertension, previous myocardial infarction, and chronic kidney disease (adjusted r2 0.44) emerged as significant factors in linear regression analysis to predict high-sensitivity cardiac troponin T.
  • High-sensitivity cardiac troponin T was best explained by a linear curve with age as ≤0.014 μg/L.
  • Patients with high-sensitivity cardiac troponin T levels>0.014 μg/L were at increased risk for all-cause mortality (hazard ratio 3.0; 95% confidence interval, 0.8-10.6; P=.02) during follow-up.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...

Your Unread Messages in Anesthesiology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Anesthesiology Articles

1 The intubation scoop (i-scoop) - A new type of laryngoscope for difficult and normal airways Anaesthesia, June 12, 2014    Clinical Article

2 A nomogram for calculating the maximum dose of local anaesthetic Anaesthesia, May 13, 2014    Clinical Article

3 Routine pre-operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures Acta Anaesthesiologica Scandinavica, June 2, 2014    Clinical Article

4 Epinephrine, vasopressin and steroids for in-hospital cardiac arrest: The right cocktail therapy? Critical Care, June 6, 2014    Clinical Article

5 Major incidents and complications in otherwise healthy patients undergoing elective procedures: Results based on 1.37 million anaesthetic procedures British Journal of Anesthesia, June 25, 2014    Review Article

6 A survey of Canadian anesthesiologists preferences in difficult intubation and cannot intubate, cannot ventilate situations Canadian Journal of Anesthesia, June 11, 2014    Clinical Article

7 Statins and the risk of liver injury: A population-based case-control study Pharmacoepidemiology and Drug Safety, June 3, 2014    Clinical Article

8 Effects of fentanyl administration before induction of anesthesia and placement of the Laryngeal Mask Airway: A randomized, placebo-controlled trial Journal of Clinical Anesthesia, May 29, 2014    Clinical Article

9 Major incidents and complications in otherwise healthy patients undergoing elective procedures: Results based on 1.36 million anaesthetic procedures British Journal of Anesthesia, May 9, 2014    Review Article

10 Perioperative hypoxemia is common with horizontal positioning during general anesthesia and is associated with major adverse outcomes: A retrospective study of consecutive patients Full Text BMC Anesthesiology, June 13, 2014    Free full text    Clinical Article

11 Volume of fluids administered during resuscitation for severe sepsis and septic shock and the development of the acute respiratory distress syndrome Journal of Critical Care, June 20, 2014    Clinical Article

12 Preoperative opioid use as a predictor of adverse postoperative self-reported outcomes in patients undergoing spine surgery The Journal of Bone & Joint Surgery, June 10, 2014    Evidence Based Medicine    Clinical Article

13 Outcomes, measures and recovery after ambulatory surgery and anaesthesia: A review Current Anesthesiology Reports, June 9, 2014    Review Article

14 Comparison of continuous non-invasive finger arterial pressure monitoring with conventional intermittent automated arm arterial pressure measurement in patients under general anaesthesia British Journal of Anesthesia, June 24, 2014    Clinical Article

15 The impact of etomidate on mortality in trauma patients Canadian Journal of Anesthesia, April 14, 2014    Clinical Article

16 Pre-procedure ultrasound increases the success and safety of central venous catheterization British Journal of Anesthesia, June 19, 2014    Clinical Article

17 Relationship Between Diclofenac Dose and Risk of Gastrointestinal and Cardiovascular Events: Meta-Regression Based on Two Systematic Literature Reviews Clinical Therapeutics, June 17, 2014    Clinical Article

18 A systematic review and meta-analysis of the i-gel vs laryngeal mask airway in children Anaesthesia, June 5, 2014    Evidence Based Medicine

19 Risk of new or recurrent cancer after a high perioperative inspiratory oxygen fraction during abdominal surgery British Journal of Anesthesia, June 2, 2014    Clinical Article

20 Patients with obstructive sleep apnea for ambulatory surgery: Challenges and management Current Anesthesiology Reports, June 13, 2014    Clinical Article

Indexed Journals in Anesthesiology: Anaesthesia, Anesthesia & Analgesia, Current Anaesthesia and Critical Caremore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close