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Cardiac troponin I predicts clinical outcome of patients with cancer at emergency department.

Abstract：

BACKGROUND:The prognostic ability of cardiac troponin I (TnI) has been demonstrated in general populations and among cardiovascular disease patients, but it has not been evaluated in cancer patients. HYPOTHESIS:This study assumes to have the prognostic ability of cardiac troponin in cancer patients visiting the emergency department. METHODS:Cancer patients visiting the emergency department were enrolled in this retrospective cohort study. Patients with previously known coronary artery disease or clinically indicated coronary angiography were not included. The maximal value from Siemens ADVIA Centaur troponin I Ultra assay within 24 hours was assessed. The primary endpoint was 180-day all-cause death, including cardiovascular and noncardiovascular death. RESULTS:A total of 9135 cancer patients (mean age: 63 years, male gender: 60%) were enrolled. Lowest (0.006 ng/mL), assay-specific <99th % (0.007-0.039 ng/mL), below median ≥ 99th % (0.040-0.129 ng/mL), and above median ≥ 99th % (≥0.130 ng/mL) TnI were found in 4487 (49.1%), 3158 (34.6%), 852 (9.3%), and 638 (7.0%) patients, respectively. There was 3192 (34.9%) all-cause deaths including 137 (1.5%) cardiovascular and 3047 (33.4%) noncardiovascular deaths in the 180-day follow-up period. The risks of all-cause, cardiovascular, and noncardiovascular death increased across higher TnI strata (hazard ratio [HR] = 1.3-2.9; 2.1-9.3; 1.3-1.8; P < .001, all). These findings were consistent within clinical subgroups including solid and hematologic cancers. CONCLUSIONS:Cancer patients visiting the emergency department with elevated troponin I were at increased risk of 180-day death. Cancer patients with elevated TnI may need additional evaluation or careful follow-up even without cardiovascular disease diagnosis.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Park SH,Kim T,Cha WC,Yoon H,Hwang SY,Shin TG,Sim MS,Jo I,Lee SH,Park HD,Choi JH

doi

10.1002/clc.23486

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

1585-1591

issue

12

eissn

0160-9289

issn

1932-8737

journal_volume

43

pub_type

杂志文章

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