Abstract
Background
The definition of myocardial infarction relies on elevated troponin levels. However,
elevated levels of high sensitive cardiac troponin (hs-cTnT) assays have been reported
in elderly patients without acute myocardial infarction. We sought to determine whether
elevated hs-cTnT levels have a prognostic value in stable elderly subjects without
any acute illness.
Methods
The study cohort included residents of a nursing home who were asymptomatic without
any acute medical problem. Serum hs-cTnT levels were measured, and participants were
divided into high and low hs-cTnT groups. We measured hs-cTnT levels of young healthy
volunteers as well and compared them with hs-cTnT levels of those nursing home residents.
Results
Fifty-seven nursing home residents and 14 young volunteers were included in the study.
The average age of nursing home residents was 83 ± 14 years, compared with 37 ± 3
years of the volunteers. Levels of hs-cTnT were significantly higher in the elderly
compared with the volunteers (0.02 ± 0.016 ng/mL vs 0.005 ± 0.0003 ng/mL; P < .001); accordingly, we chose a cutoff of 0.02 ng/mL hs-cTnT and divided the 57
patients into 2 subgroups for further evaluation. After adjustment for age, gender,
and glomerular filtration rate, the hs-cTnT was still an independent predictor of
1-year mortality (relative risk 2.04 [95% conficence interval, 2.009-29.45], P = .003).
Conclusions
Mild elevations of hs-cTnT levels are common in elderly patients, and hs-cTnT level
is an independent marker of mortality risk in this population. For patients older
than 70 years, a different hs-cTnT cutoff is required (eg, higher than 0.014 ng/mL).
Keywords
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Article info
Publication history
Published online: December 27, 2017
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing the manuscript.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
