PMID- 30019381
OWN - NLM
STAT- MEDLINE
DCOM- 20181107
LR  - 20181107
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 41
IP  - 8
DP  - 2018 Aug
TI  - Non-coronary predictors of elevated high-sensitive cardiac troponin T (hs-cTnT)
      levels in an unselected emergency patient cohort.
PG  - 1055-1061
LID - 10.1002/clc.23026 [doi]
AB  - BACKGROUND: Aim of this study was to evaluate the predictors of hs-cTnT in a
      non-ACS patient cohort admitted to the emergency department. HYPOTHESIS: Atrial
      fibrillation and hypertension may not always be sufficient for elevation for
      hs-cTnT. METHODS: We performed a retrospective, single center study encompassing 
      in total 1003 patients. Individuals were retrospectively divided in ACS- and
      non-ACS patients by two independent investigators reviewing the medical records. 
      In order to identify predictors of hs-cTnT elevation hazard ratios were
      calculated for age, gender, vital signs, cardiovascular risk factors, LVEF, serum
      levels of CRP, hemoglobin, and creatinine. Elevation of hs-cTnT was defined by
      exceeding 14 ng/L (upper reference limit [URL]). RESULTS: About 987 patients were
      included while 25 patients were excluded because of missing data. 307 patients
      (31.4%) met the current guideline requirements of diagnosing an ACS, whereas 671 
      patients (68.6%) were hospitalized with excluded ACS. In the multivariate
      analysis age, anemia, CRP, creatinine, and reduced systolic left ventricular
      ejection fraction were independent predictors of elevated troponin T levels in
      the non-ACS group. However, hypertensive systolic blood pressure, atrial
      fibrillation and tachycardia were not predictive for Troponin T elevation in
      non-ACS patients in this multivariate analysis. CONCLUSIONS: In an unselected,
      non-ACS patient cohort age, chronic renal failure, inflammatory state, and
      reduced left ventricular systolic function were associated with hs-cTnT levels
      above the upper reference limit. Rather, often supposed predictors as atrial
      fibrillation, hypertension, and tachycardia cannot sufficiently explain increased
      hs-cTnT in our study. Hence, further studies are needed to assess whether
      isolated hypertension, tachycardia, or atrial fibrillation sufficiently explain
      elevated hs-cTnT.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Berger, Manfred
AU  - Berger M
AUID- ORCID: http://orcid.org/0000-0002-7168-3641
AD  - Department of Cardiology, Hospital Barmherzige Brueder, Regensburg, Germany.
FAU - Emir, Meryem
AU  - Emir M
AD  - Department of Cardiology, Hospital Barmherzige Brueder, Regensburg, Germany.
FAU - Brunnler, Tanja
AU  - Brunnler T
AD  - Emergency Department, Hospital Barmherzige Brueder, Regensburg, Germany.
FAU - Rockmann, Felix
AU  - Rockmann F
AD  - Emergency Department, Hospital Barmherzige Brueder, Regensburg, Germany.
FAU - Lehmann, Ralf
AU  - Lehmann R
AD  - Department of Cardiology, Hospital Barmherzige Brueder, Regensburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20180816
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Biomarkers)
RN  - 0 (Troponin T)
SB  - IM
MH  - Acute Coronary Syndrome/blood/*diagnosis
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/*blood/diagnosis
MH  - Biomarkers/blood
MH  - *Emergency Service, Hospital
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension/*blood/diagnosis
MH  - Kidney Failure, Chronic/*blood/diagnosis
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Troponin T/*blood
MH  - Young Adult
OTO - NOTNLM
OT  - acute coronary syndrome
OT  - atrial fibrillation
OT  - cardiac troponin T
OT  - emergency patient cohort
OT  - hypertension
OT  - predictors
EDAT- 2018/07/19 06:00
MHDA- 2018/11/08 06:00
CRDT- 2018/07/19 06:00
PHST- 2018/04/22 00:00 [received]
PHST- 2018/06/26 00:00 [revised]
PHST- 2018/07/07 00:00 [accepted]
PHST- 2018/07/19 06:00 [pubmed]
PHST- 2018/11/08 06:00 [medline]
PHST- 2018/07/19 06:00 [entrez]
AID - 10.1002/clc.23026 [doi]
PST - ppublish
SO  - Clin Cardiol. 2018 Aug;41(8):1055-1061. doi: 10.1002/clc.23026. Epub 2018 Aug 16.