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High-sensitivity cardiac troponin T levels in the emergency department in patients with chest pain but no myocardial infarction
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
Karolinska Univ Hosp, Dept Emergency Med, C1-63, S-14186 Stockholm, Sweden.;Karolinska Inst, Dept Internal Med, Stockholm, Sweden..
Karolinska Univ Hosp, Dept Emergency Med, C1-63, S-14186 Stockholm, Sweden.;Karolinska Inst, Dept Internal Med, Stockholm, Sweden..
Univ Gothenburg, Sahlgrenska Univ Hosp, Sahlgrenska Acad, Dept Clin Chem & Transfus Med, Gothenburg, Sweden..
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2017 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 228, 253-259 p.Article in journal (Refereed) Published
Abstract [en]

Background: High-sensitivity cardiac troponin T (hs-cTnT) was recently introduced into clinical practice. The increased sensitivity has decreased the specificity. We aimed to determine the predictors for and prevalence of hs-cTnT levels above the 99th percentile in a stable population of patients without myocardial infarction (MI) who sought medical attention for chest pain in the emergency department. Methods: We included 11,847 patients with chest pain and at least one hs-cTnT measurement during 2011 and 2012. Patients with any acute reasons for an elevated hs-cTnT level were excluded. We used logistic regression to calculate adjusted odds ratios with 95% confidence intervals for the association between patient characteristics and hs-cTnT levels of >14 ng/L. We also determined 50th, 75th, 97.5th, and 99th percentile values of hs-cTnT levels in relation to age, sex, estimated glomerular filtration rate (eGFR), and presence or absence of comorbidities. Results: In total, 1360 (11%) patients had hs-cTnT levels of >14 ng/L. Men had higher troponin levels than women, and older patients had higher levels than younger patients. The strongest predictor of an elevated troponin level was a reduced eGFR. The 99th percentile for hs-cTnT among all men and among women <50 years of age with normal renal function was 20 and 12 ng/L, respectively; this level increased to 44 and 36 ng/L, respectively, at the age of 70-79 years. Conclusions: A hs-cTnT level above the 99th percentile in patients with chest pain but no MI is common and is related to sex, age, and eGFR.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2017. Vol. 228, 253-259 p.
Keyword [en]
High-sensitivity cardiac troponin T, Emergency department, Normal level, No myocardial infarction
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-319113DOI: 10.1016/j.ijcard.2016.11.087ISI: 000393408600042PubMedID: 27865194OAI: oai:DiVA.org:uu-319113DiVA: diva2:1086556
Funder
Swedish Heart Lung Foundation
Available from: 2017-04-03 Created: 2017-04-03 Last updated: 2017-04-03Bibliographically approved

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