Troponin assessment in patients admitted to the emergency department with atrial fibrillation: which role in daily clinical practice?
Atrial fibrillation (AF) is the most common dysrhythmia observed and managed by emergency physicians in daily clinical practice. According to the latest epidemiological studies, the prevalence of AF rises with the aging of the general population , with clear implications in resource utilization and health costs. Moreover, it has been estimated that the number of patients with AF will rise to about 5.6 million in 2050 from its current number of 2.3 million cases . Frequently, AF patients are admitted to the emergency department (ED) after the dysrhythmia onset, and, more in general, about 80% of the AF subjects will be admitted into a cardiological or internal medicine unit during the course of their illness . Previous investigations and trials involving AF subjects have mainly investigated and elucidated clinical and therapeutical aspects of the disease, as the link between AF and the risk or the prevention of ischemic stroke. Conversely, data regarding the prognostic role of...
Compliance with ethical standards
Conflict of interest
Francesco Zanon received a modest speaker fee from Boston Scientific, Livanova, Medtronic and St jude Medical. The other authors declare that they have no conflict of interest.
Statement of human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All patients did provide informed consent.
- 1.Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV (2001) Singer DE Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 285(18):2370–2375CrossRefPubMedGoogle Scholar
- 2.Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, Seward JB, Tsang TS (2006) Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation 114(2):119–125CrossRefPubMedGoogle Scholar
- 3.Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, Kellen JC, Greene HL, Mickel MC, Dalquist JE, Corley SD, Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators (2002) A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med 347(23):1825–1833CrossRefPubMedGoogle Scholar
- 4.Hijazi Z, Siegbahn A, Andersson U, Lindahl B, Granger CB, Alexander JH, Atar D, Gersh BJ, Hanna M, Harjola VP, Horowitz J, Husted S, Hylek EM, Lopes RD, McMurray JJ, Wallentin L (2015) Comparison of cardiac troponins I and T measured with high-sensitivity methods for evaluation of prognosis in atrial fibrillation: an ARISTOTLE substudy. Clin Chem 61(2):368–378CrossRefPubMedGoogle Scholar
- 6.Augusto JB, Santos MB, Roque D, Faria D, Urzal J, Morais J, Gil V, Morais C (2017) Mild troponin elevation in patients admitted to the emergency department with atrial fibrillation: 30-day post-discharge prognostic significance. Intern Emerg Med. https://doi.org/10.1007/s11739-017-1777-7 PubMedGoogle Scholar