OBJECTIVE: Cardiac troponin levels help risk-stratify patients presenting with an acute coronary syndrome. Although cardiac troponin levels may be elevated in patients presenting with non-acute coronary syndrome conditions, specific diagnoses and long-term outcomes within that cohort are unclear. METHODS: By using the Veterans Affairs centralized databases, we identified all hospitalized patients in 2006 who had a troponin assay obtained during their initial reference hospitalization. On the basis of the diagnostic codes of the International Classification of Diseases, 9th Revision, primary diagnoses were categorized as acute coronary syndrome or non-acute coronary syndrome conditions. RESULTS: Of a total of 21,668 patients with an elevated troponin level who were discharged from the hospital, 12,400 (57.2%) had a non-acute coronary syndrome condition. Among that cohort, the most common diagnostic category involved the cardiovascular system, and congestive heart failure (N=1661) and chronic coronary artery disease (N=1648) accounted for the major classifications. At 1 year after hospital discharge, mortality in patients with a non-acute coronary syndrome condition was 22.8% and was higher than in the acute coronary syndrome cohort (odds ratio 1.39; 95% confidence interval, 1.30-1.49). Despite the high prevalence of cardiovascular diseases in patients with a non-acute coronary syndrome diagnosis, use of cardiac imaging within 90 days of hospitalization was low compared with that in patients with acute coronary syndrome (odds ratio 0.25; 95% confidence interval, 0.23-0.27). CONCLUSIONS: Hospitalized patients with an elevated troponin level more often have a primary diagnosis that is not an acute coronary syndrome. Their long-term survival is poor and justifies novel diagnostic or therapeutic strategy-based studies to target the highest risk subsets before hospital discharge. Published by Elsevier Inc.
OBJECTIVE: Cardiac troponin levels help risk-stratify patients presenting with an acute coronary syndrome. Although cardiac troponin levels may be elevated in patients presenting with non-acute coronary syndrome conditions, specific diagnoses and long-term outcomes within that cohort are unclear. METHODS: By using the Veterans Affairs centralized databases, we identified all hospitalized patients in 2006 who had a troponin assay obtained during their initial reference hospitalization. On the basis of the diagnostic codes of the International Classification of Diseases, 9th Revision, primary diagnoses were categorized as acute coronary syndrome or non-acute coronary syndrome conditions. RESULTS: Of a total of 21,668 patients with an elevated troponin level who were discharged from the hospital, 12,400 (57.2%) had a non-acute coronary syndrome condition. Among that cohort, the most common diagnostic category involved the cardiovascular system, and congestive heart failure (N=1661) and chronic coronary artery disease (N=1648) accounted for the major classifications. At 1 year after hospital discharge, mortality in patients with a non-acute coronary syndrome condition was 22.8% and was higher than in the acute coronary syndrome cohort (odds ratio 1.39; 95% confidence interval, 1.30-1.49). Despite the high prevalence of cardiovascular diseases in patients with a non-acute coronary syndrome diagnosis, use of cardiac imaging within 90 days of hospitalization was low compared with that in patients with acute coronary syndrome (odds ratio 0.25; 95% confidence interval, 0.23-0.27). CONCLUSIONS: Hospitalized patients with an elevated troponin level more often have a primary diagnosis that is not an acute coronary syndrome. Their long-term survival is poor and justifies novel diagnostic or therapeutic strategy-based studies to target the highest risk subsets before hospital discharge. Published by Elsevier Inc.
Authors: Charles Maynard; Elliott Lowy; John Rumsfeld; Ann E Sales; Haili Sun; Branko Kopjar; Barbara Fleming; Robert L Jesse; Roxane Rusch; Stephan D Fihn Journal: Arch Intern Med Date: 2006-07-10
Authors: Shamir R Mehta; Christopher P Cannon; Keith A A Fox; Lars Wallentin; William E Boden; Rudolf Spacek; Petr Widimsky; Peter A McCullough; David Hunt; Eugene Braunwald; Salim Yusuf Journal: JAMA Date: 2005-06-15 Impact factor: 56.272
Authors: Peter Ammann; Marco Maggiorini; Osmund Bertel; Edgar Haenseler; Helen I Joller-Jemelka; Erwin Oechslin; Elisabeth I Minder; Hans Rickli; Thomas Fehr Journal: J Am Coll Cardiol Date: 2003-06-04 Impact factor: 24.094
Authors: Thomas W Wallace; Shuaib M Abdullah; Mark H Drazner; Sandeep R Das; Amit Khera; Darren K McGuire; Frank Wians; Marc S Sabatine; David A Morrow; James A de Lemos Journal: Circulation Date: 2006-04-17 Impact factor: 29.690
Authors: Eugene Braunwald; Elliott M Antman; John W Beasley; Robert M Califf; Melvin D Cheitlin; Judith S Hochman; Robert H Jones; Dean Kereiakes; Joel Kupersmith; Thomas N Levin; Carl J Pepine; John W Schaeffer; Earl E Smith; David E Steward; Pierre Theroux; Raymond J Gibbons; Joseph S Alpert; David P Faxon; Valentin Fuster; Gabriel Gregoratos; Loren F Hiratzka; Alice K Jacobs; Sidney C Smith Journal: Circulation Date: 2002-10-01 Impact factor: 29.690
Authors: Alexander Illmann; Thomas Riemer; Raimund Erbel; Evangelos Giannitsis; Christian Hamm; Michael Haude; Gerd Heusch; Lars S Maier; Thomas Münzel; Claus Schmitt; Burghard Schumacher; Jochen Senges; Thomas Voigtländer; Harald Mudra Journal: Clin Res Cardiol Date: 2014-01 Impact factor: 5.460
Authors: Brian R Weil; Rebeccah F Young; Xiaomeng Shen; Gen Suzuki; Jun Qu; Saurabh Malhotra; John M Canty Journal: JACC Basic Transl Sci Date: 2017-03-29
Authors: Maame Yaa A B Yiadom; Jeremy Greenberg; Holly M Smith; Douglas B Sawyer; Dandan Liu; Jahred Carlise; Laura Tortora; Alan B Storrow Journal: Dis Markers Date: 2016-03-24 Impact factor: 3.434