• Jason M Baron, Elizabeth L Lewandrowski, James L Januzzi, Ednan K Bajwa, B Taylor Thompson, and Kent B Lewandrowski.
• Bigelow Building, Room 504, 55 Fruit St, Boston, MA 02114; klewandrowski@partners.org.
• Am. J. Clin. Pathol. 2014 Apr 1; 141 (4): 488-93.

ObjectivesTo assess the frequency, magnitude, and prognostic significance of elevations in cardiac troponin T in noncardiac critically ill patients, including elevations at levels below the limit of detection of traditional assays.MethodsUsing a high-sensitivity assay, we measured troponin T (high-sensitivity troponin T [hsTnT]) in 451 unique patients within 12 hours of their admission to a noncardiac medical intensive care unit. Outcomes of patients, grouped by hsTnT level, were compared.ResultsOverall, 98% of the study patients had detectable levels of hsTnT (>3 ng/L), and 33% had levels above the diagnostic cutoff of a traditional fourth-generation cardiac troponin T assay. Patient groups with higher hsTnT levels had markedly higher rates of in-hospital mortality (P < .001) and longer stays in the hospital and intensive care unit (P < .01).ConclusionsIn noncardiac critically ill patients, cardiac troponin T elevations are common but often at levels undetectable by traditional assays. hsTnT elevations predict a more complex clinical course and an increased risk of death.

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