Andreas Roos1, Anton Hellgren1, Farshid Rafatnia2, Ola Hammarsten3, Rickard Ljung4, Axel C Carlsson5, Martin J Holzmann6. 1. Department of Emergency Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 2. Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Internal Medicine, NYU Lutheran Medical Center, Brooklyn, NY, USA. 3. Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 5. Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden. 6. Department of Emergency Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: martin.holzmann@karolinska.se.
Abstract
BACKGROUND: Elevated troponin levels, in patients without myocardial infarction (MI), are associated with increased mortality. In an observational cohort study we aimed to assess how patients with elevated high-sensitivity cardiac troponin T (hs-cTnT) levels, and no MI are investigated and followed up, compared to patients with MI. METHODS: During January 1, 2011 to December 31, 2012, all patients >25years of age, with chest pain and elevated hs-cTnT levels or MI, at the Karolinska University Hospital were included. We calculated risk ratios (RR) with 95% confidence intervals (CI) for echocardiographies, stress tests, and follow-up, and compared medication in patients with and without MI. RESULTS: 1848 patients with elevated hs-cTnT levels but no MI, of whom 871 (47%) had no prior heart disease, and 667 patients with MI were included. Echocardiography was performed in 609 patients (33%) without MI and 580 (87%) with MI (adjusted RR 0.42; 95% CI, 0.37-0.48). Follow-up was planned for 856 (46%) patients without MI and 611 (92%) with MI (adjusted RR 0.54; 95% CI, 0.48-0.60). Among patients without MI and no heart disease who underwent echocardiography 46 (14%) had a left ventricular ejection fraction of ≤40%, and on stress tests 27 (37%) had findings associated with ischemia. Platelet inhibitors and statins were started in 266 (25%) and 199 (17%) patients without MI, respectively, compared with 424 (93%), and 416 (86%) patients with MI. CONCLUSIONS: Patients with elevated hs-cTnT levels and no MI are rarely investigated for detection of cardiac disease or followed up, or started on cardiovascular medication that potentially could prevent future cardiovascular events and death. Copyright Â
BACKGROUND: Elevated troponin levels, in patients without myocardial infarction (MI), are associated with increased mortality. In an observational cohort study we aimed to assess how patients with elevated high-sensitivity cardiac troponin T (hs-cTnT) levels, and no MI are investigated and followed up, compared to patients with MI. METHODS: During January 1, 2011 to December 31, 2012, all patients >25years of age, with chest pain and elevated hs-cTnT levels or MI, at the Karolinska University Hospital were included. We calculated risk ratios (RR) with 95% confidence intervals (CI) for echocardiographies, stress tests, and follow-up, and compared medication in patients with and without MI. RESULTS: 1848 patients with elevated hs-cTnT levels but no MI, of whom 871 (47%) had no prior heart disease, and 667 patients with MI were included. Echocardiography was performed in 609 patients (33%) without MI and 580 (87%) with MI (adjusted RR 0.42; 95% CI, 0.37-0.48). Follow-up was planned for 856 (46%) patients without MI and 611 (92%) with MI (adjusted RR 0.54; 95% CI, 0.48-0.60). Among patients without MI and no heart disease who underwent echocardiography 46 (14%) had a left ventricular ejection fraction of ≤40%, and on stress tests 27 (37%) had findings associated with ischemia. Platelet inhibitors and statins were started in 266 (25%) and 199 (17%) patients without MI, respectively, compared with 424 (93%), and 416 (86%) patients with MI. CONCLUSIONS:Patients with elevated hs-cTnT levels and no MI are rarely investigated for detection of cardiac disease or followed up, or started on cardiovascular medication that potentially could prevent future cardiovascular events and death. Copyright Â
Authors: Taseer Ahmad; Taous Khan; Tahira Tabassum; Yahya S Alqahtani; Mater H Mahnashi; Bandar A Alyami; Ali O Alqarni; Mohammed Y Alasmary; Sultan A Almedhesh; Abdul Jabbar Shah Journal: Curr Issues Mol Biol Date: 2022-07-16 Impact factor: 2.976
Authors: Nils A Sörensen; Sebastian Ludwig; Nataliya Makarova; Johannes T Neumann; Jonas Lehmacher; Tau S Hartikainen; Paul M Haller; Till Keller; Stefan Blankenberg; Dirk Westermann; Tanja Zeller; Niklas Schofer Journal: Biomolecules Date: 2019-09-09