• Kasper Iversen, Lars Køber, Jens Peter Gøtze, Morten Dalsgaard, Henrik Nielsen, Søren Boesgaard, Morten Bay, Vibeke Kirk, and Olav Wendelboe Nielsen.
• Department of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of Cardiology and Endocrinology, Hillerød Hospital, Hillerød, Denmark. Electronic address: Kasper.iversen@dadlnet.dk.
• Int. J. Cardiol. 2013 Sep 30;168(2):818-24.

BackgroundCardiac troponins are diagnostic markers in acute coronary syndrome and prognostic markers in stable coronary disease. Small increases are occasionally observed in patients with non-cardiac disease, but the prevalence and prognostic value of increased troponin in the general hospitalized population are unknown.MethodsConsecutive patients aged >40 years admitted to a district hospital between 1 April 1998 and 31 March 1999 were included. A comprehensive medical interview and clinical examination were performed including echocardiography and measurement of natriuretic peptides and troponin T with a high-sensitivity assay (hs-TnT).ResultsSerum for analyses of hs-TnT was available from 1176 patients. Patients were 73.7 years old on average (interquartile range, 64.5-80.0 years), 59.2% were women and median follow-up was 11.4 years. The prevalence of elevated hs-TnT (> 99(th) percentile) was 57.1% of the entire cohort and 52.3% of patients with non-cardiac diagnoses. hs-TnT above the median (17 ng/L) was associated in univariate analysis with a 3-fold higher mortality in the entire population (multivariate hazard rate (HR) from 1.3 to 1.8 for 1 and 11 year mortality, respectively). In patients without past or present ischemic heart disease hs-TnT in the upper quartile (above 34.8 ng/L) was associated in univariate analysis with a 5-fold higher mortality risk (multivariable HR 1.8 to 2.2 for 1 and 11 year mortality, respectively).ConclusionMore than half of the hospitalized patients had hs-TnT levels above the 99(th) percentile. Elevated hs-TnT is a strong mortality risk marker in general hospitalized older patients.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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