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Distribution of contemporary sensitivity troponin in the emergency department and relationship to 30-day mortality: The CHARIOT-ED substudy

Distribution of contemporary sensitivity troponin in the emergency department and relationship to 30-day mortality: The CHARIOT-ED substudy
Distribution of contemporary sensitivity troponin in the emergency department and relationship to 30-day mortality: The CHARIOT-ED substudy

BACKGROUND: Contemporary 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. OBJECTIVES: Our 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. METHOD: In 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. RESULTS: In 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. CONCLUSION: Increasing 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.

Emergency department, acute coronary syndrome, contemporary sensitivity troponin, myocardial infarction, myocardial injury, Myocardial infarction, Contemporary sensitivity troponin, Acute coronary syndrome, Myocardial injury
1470-2118
528-534
Hinton, Jonathan
9b048c26-84f8-4536-937b-7e1c50c94ac6
Mariathas, Mark
5187ff3f-c073-45ad-9ce4-f83faf2723a3
Gabara, Lavinia
bea992dc-b68c-4f56-b2c3-6a0ecf7a420d
Nicholas, Zoe
98403583-c418-45ad-836b-1831517dcc5f
Allan, Rick
2726ab31-1430-4275-becc-461fb4023442
Ramamoorthy, Sanjay
b0d15032-4158-4661-8124-58071e8dc900
Mamas, Mamas A
5e691a39-5922-435c-9ce0-53a74a66a23f
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Cook, Paul
3b27de79-469b-4ad2-b728-a92ee168398f
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Hinton, Jonathan
9b048c26-84f8-4536-937b-7e1c50c94ac6
Mariathas, Mark
5187ff3f-c073-45ad-9ce4-f83faf2723a3
Gabara, Lavinia
bea992dc-b68c-4f56-b2c3-6a0ecf7a420d
Nicholas, Zoe
98403583-c418-45ad-836b-1831517dcc5f
Allan, Rick
2726ab31-1430-4275-becc-461fb4023442
Ramamoorthy, Sanjay
b0d15032-4158-4661-8124-58071e8dc900
Mamas, Mamas A
5e691a39-5922-435c-9ce0-53a74a66a23f
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Cook, Paul
3b27de79-469b-4ad2-b728-a92ee168398f
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4

Hinton, Jonathan, Mariathas, Mark, Gabara, Lavinia, Nicholas, Zoe, Allan, Rick, Ramamoorthy, Sanjay, Mamas, Mamas A, Mahmoudi, Michael, Cook, Paul and Curzen, Nick (2020) Distribution of contemporary sensitivity troponin in the emergency department and relationship to 30-day mortality: The CHARIOT-ED substudy. Clinical Medicine, 20 (6), 528-534. (doi:10.7861/clinmed.2020-0267).

Record type: Article

Abstract

BACKGROUND: Contemporary 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. OBJECTIVES: Our 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. METHOD: In 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. RESULTS: In 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. CONCLUSION: Increasing 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.

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More information

e-pub ahead of print date: 16 November 2020
Published date: 16 November 2020
Additional Information: © Royal College of Physicians 2020. All rights reserved.
Keywords: Emergency department, acute coronary syndrome, contemporary sensitivity troponin, myocardial infarction, myocardial injury, Myocardial infarction, Contemporary sensitivity troponin, Acute coronary syndrome, Myocardial injury

Identifiers

Local EPrints ID: 448523
URI: http://eprints.soton.ac.uk/id/eprint/448523
ISSN: 1470-2118
PURE UUID: 375d6600-d5cd-4e36-ab44-c273b7753bd7
ORCID for Michael Mahmoudi: ORCID iD orcid.org/0000-0003-1293-8461
ORCID for Nick Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 23 Apr 2021 16:36
Last modified: 28 Apr 2022 02:14

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Contributors

Author: Jonathan Hinton
Author: Mark Mariathas
Author: Lavinia Gabara
Author: Zoe Nicholas
Author: Rick Allan
Author: Sanjay Ramamoorthy
Author: Mamas A Mamas
Author: Paul Cook
Author: Nick Curzen ORCID iD

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