Prognostic value of cardiac troponin I assay in hospitalized elderly patients
- 49 Downloads
Cardiac troponin I (cTnI) has been poorly studied in elderly inpatients.
This study wanted to assess factors influencing the increase in cTnI and its prognostic value in hospitalized elderly patients.
354 elderly (mean age of 84.8 ± 6.9 years) patients consecutively admitted in the Geriatrics Division in Padua were tested for cTnI levels assay during the hospital stay. Number of subsequent patient deaths at 6 months and 2 years were registered.
Of the 354 patients, 27 (7.6%) died in hospital; their levels were not significantly higher or more frequently positive on cTnI than those of the remainder of the sample. 71 (20.01%) patients died within 6 months of being discharged, and in-hospital positive cTnI levels emerged as a mortality risk factor in this group [unadjusted HR 1.13 (1.04–1.23); p = 0.004]. At 2 years, a total of 174 patients (49.2%) had died, but in-hospital pathological cTnI levels were not a mortality risk factor in this group.
It should be noted that cTnI level was a risk factor for mortality at 6 months but no longer at 2 years after an elderly patient’s hospitalization. This finding may relate to patients’ limited physiological reserves or be driven by the fact that the elderly tend to receive fewer evidence-based treatments, and to be managed more conservatively than younger patients.
In the multidimensional analysis of older patients, troponin I can be used to stratify patients and assess mortality risk at 6 months, but not at 2 years.
KeywordsAging Coronary heart disease Elderly patients Cardiac troponin I Hospitalization
This study did not receive external funding.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of human and animal rights
All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.
Informed consent was obtained from all individual participants included in the study.
- 1.Roffi Authors/TaskFMembers, Patrono M, Collet C, Mueller J-P et al (2015) ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2015:ehv320Google Scholar
- 5.Rains MG, Laney CA, Bailey AL et al (2014) Biomarkers of acute myocardial infarction in the elderly: troponin and beyond. Clin Interv Aging 9:1081–1090Google Scholar
- 14.Bliss MR, McLaren R, Exton-Smith AN (1966) Mattresses for preventing pressure sores in geriatric patients. Mon Bull Minist Health Public Health Lab Serv 25:238–268Google Scholar
- 18.Thorsteinsdottir I, Aspelund T, Gudmundsson E et al (2016) High-sensitivity cardiac troponin I is a strong predictor of cardiovascular events and mortality in the AGES-Reykjavik Community-Based Cohort of Older Individuals. Methods 630:623–630Google Scholar