Non-acute myocardial infarction-related causes of elevated high-sensitive troponin T in the emergency room: a cross-sectional analysis

Lindner, Gregor; Pfortmüller, Carmen Andrea; Braun, Christian Tasso; Exadaktylos, Aristomenis Konstantinos (2014). Non-acute myocardial infarction-related causes of elevated high-sensitive troponin T in the emergency room: a cross-sectional analysis. Internal and emergency medicine, 9(3), pp. 335-339. Springer 10.1007/s11739-013-1030-y

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To systematically investigate putative causes of non-coronary high-sensitive troponin elevations in patients presenting to a tertiary care emergency department. In this cross-sectional analysis, patients who received serial measurements of high-sensitive troponin T between 1 August 2010 and 31 October 2012 at the Department of Emergency Medicine were included. The following putative causes were considered to be associated with non-acute coronary syndrome-related increases in high-sensitive troponin T: acute pulmonary embolism, renal insufficiency, aortic dissection, heart failure, peri-/myocarditis, strenuous exercise, rhabdomyolysis, cardiotoxic chemotherapy, high-frequency ablation therapy, defibrillator shocks, cardiac infiltrative disorders (e.g., amyloidosis), chest trauma, sepsis, shock, exacerbation of chronic obstructive pulmonary disease, and diabetic ketoacidosis. During the study period a total of 1,573 patients received serial measurements of high-sensitive troponin T. Of these, 175 patients were found to have acute coronary syndrome leaving 1,398 patients for inclusion in the study. In 222 (30 %) of patients, no putative cause described in the literature could be attributed to the elevation in high-sensitive troponin T observed. The most commonly encountered mechanism underlying the troponin T elevation was renal insufficiency that was present in 286 patients (57 %), followed by cerebral ischemia in 95 patients (19 %), trauma in 75 patients (15 %) and heart failure in 41 patients (8 %). Non-acute coronary syndrome-associated elevation of high-sensitive troponin T levels is commonly observed in the emergency department. Renal insufficiency and acute cerebral events are the most common conditions associated with high-sensitive troponin T elevation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Lindner, Gregor; Pfortmüller, Carmen; Braun, Christian Tasso and Exadaktylos, Aristomenis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1828-0447

Publisher:

Springer

Language:

English

Submitter:

Patricia Rajaonina

Date Deposited:

11 Sep 2014 12:27

Last Modified:

09 Nov 2015 10:52

Publisher DOI:

10.1007/s11739-013-1030-y

PubMed ID:

24326466

Uncontrolled Keywords:

Cardiac biomarkers, Emergency department, Renal insufficiency, Troponin

URI:

https://boris.unibe.ch/id/eprint/47282

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