• Jonathan Hinton, Mark Mariathas, Lavinia Gabara, Zoe Nicholas, Rick Allan, Sanjay Ramamoorthy, Mamas A Mamas, Michael Mahmoudi, Paul Cook, and Nick Curzen.
• University Hospital Southampton NHS Foundation Trust, Southampton, UK and University of Southampton, Southampton, UK jonathan.hinton@uhs.nhs.uk.
• Clin Med (Lond). 2020 Nov 1; 20 (6): 528534528-534.

BackgroundContemporary sensitivity troponin (cs-cTn) concentrations above the upper limit of normal (ULN) are seen in a wide range of clinical conditions and evidence is growing that suggests cs-cTn may be a biomarker of future morbidity and mortality.ObjectivesOur aim was to test the hypothesis that cs-cTn, measured in the emergency department, may be a biomarker for 30-day mortality, irrespective of the patient's presentation.MethodIn all 5,708 consecutive cases, contemporary sensitivity troponin I (cs-cTnI) was measured either as requested by the clinical team or as part of the study, in which case both the clinical team and the patient were unaware of the result. Basic demographics were available from the original study and 30-day mortality was derived from NHS Digital data.ResultsIn patients whose cs-cTnI test was requested solely as part of the study, 30-day mortality increased with increasing cs-cTnI concentrations (0% with undetectable concentrations to 14.7% with concentrations above the ULN). Multivariable Cox regression analysis showed that log(10)cs-cTnI concentration was independently associated with 30-day mortality.ConclusionIncreasing cs-cTnI concentrations are associated with higher short-term mortality as well as length of stay. As such, cs-cTnI measurements may provide useful prognostic information.© Royal College of Physicians 2020. All rights reserved.

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