PMID- 32743043
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220416
IS  - 2352-9067 (Print)
IS  - 2352-9067 (Electronic)
IS  - 2352-9067 (Linking)
VI  - 30
DP  - 2020 Oct
TI  - Comparative outcome analysis of stable mildly elevated high sensitivity troponin 
      T in patients presenting with chest pain. A single-center retrospective cohort 
      study.
PG  - 100586
LID - 10.1016/j.ijcha.2020.100586 [doi]
LID - 100586
AB  - BACKGROUND: The ideal high-sensitivity troponin (hsTn) cutoff for identifying 
      those at low risk of 30 days events is debated; however, the 99th percentile 
      overall or gender-specific upper reference limit (URL) is most commonly used. The 
      magnitude of risk and the best management strategy for those with low-level hsTn 
      elevation hasn't been extensively studied. METHODS: We conducted a retrospective 
      cohort analysis including 4396 chest pain patients (542 with low-level hsTn 
      elevation) who ruled out for myocardial infarction (MI), had a stable 
      high-sensitivity troponin T (hsTnT) levels (defined as < 5 ng/l 
      inter-measurements increase in hsTnT levels), and were discharged from the 
      emergency department without further ischemic testing. The aim of the study was 
      to compare the 30-day incidence of adverse cardiac events (ACE) between patients 
      with undetectable high-sensitivity troponin T (hsTnT) (group 1), patients with 
      hsTnT within the 99th percentile sex-specific URL (group 2), and patients with 
      low-level hsTnT elevation (between the 99th percentile URL and </= 50 ng/l) (group 
      3). RESULTS: 30-day event rates were very low 0.1%, 0.6%, and 0.4% for hsTnT 
      groups 1, 2, and 3 respectively (overall P = 0.041, for groups 2 & 3 interaction 
      P = 0.74). 30-day all-cause mortality, as well as 1-year all-cause and 
      cardiovascular mortalities, occurred more frequently in those with low-level 
      hsTnT elevation as did 1-year composite ACE. CONCLUSION: In conclusion, 30-day 
      adverse event rates were very low in those with stable low-level hsTnT elevation 
      who ruled out for MI and were discharged from the emergency department without 
      further inpatient testing.
CI  - (c) 2020 The Author(s).
FAU - Mahmoud, Osama
AU  - Mahmoud O
AD  - Heart Institute, Geisinger Medical Center, United States.
FAU - Mahmaljy, Hadi
AU  - Mahmaljy H
AD  - Heart Institute, Geisinger Medical Center, United States.
FAU - Youniss, Mohamed
AU  - Youniss M
AD  - Heart Institute, Geisinger Medical Center, United States.
FAU - Hernandez Campoverde, Edwin
AU  - Hernandez Campoverde E
AD  - Heart Institute, Geisinger Medical Center, United States.
FAU - Elias, Hadi
AU  - Elias H
AD  - Heart Institute, Geisinger Medical Center, United States.
FAU - Stanton, Matthew
AU  - Stanton M
AD  - Department of Internal Medicine, Geisinger Medical Center, United States.
FAU - Patel, Maulin
AU  - Patel M
AD  - Department of Internal Medicine, Geisinger Medical Center, United States.
FAU - Hashmi, Insia
AU  - Hashmi I
AD  - Department of Internal Medicine, Geisinger Medical Center, United States.
FAU - Young, Katelyn
AU  - Young K
AD  - Department of Internal Medicine, Geisinger Medical Center, United States.
FAU - Kuppuraju, Rajesh
AU  - Kuppuraju R
AD  - Department of Internal Medicine, Geisinger Medical Center, United States.
FAU - Jacobs, Steven
AU  - Jacobs S
AD  - Department of Internal Medicine, Geisinger Medical Center, United States.
FAU - Alsaid, Amro
AU  - Alsaid A
AD  - Heart Institute, Geisinger Medical Center, United States.
LA  - eng
PT  - Journal Article
DEP - 20200723
PL  - Ireland
TA  - Int J Cardiol Heart Vasc
JT  - International journal of cardiology. Heart & vasculature
JID - 101649525
PMC - PMC7385443
OTO - NOTNLM
OT  - Acute chest pain
OT  - Chest pain triage
OT  - High-sensitivity troponin
OT  - Stable low-level high sensitivity troponin elevation
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2020/08/04 06:00
MHDA- 2020/08/04 06:01
PMCR- 2020/07/23
CRDT- 2020/08/04 06:00
PHST- 2020/05/11 00:00 [received]
PHST- 2020/06/23 00:00 [revised]
PHST- 2020/06/26 00:00 [accepted]
PHST- 2020/08/04 06:00 [entrez]
PHST- 2020/08/04 06:00 [pubmed]
PHST- 2020/08/04 06:01 [medline]
PHST- 2020/07/23 00:00 [pmc-release]
AID - S2352-9067(20)30284-0 [pii]
AID - 100586 [pii]
AID - 10.1016/j.ijcha.2020.100586 [doi]
PST - epublish
SO  - Int J Cardiol Heart Vasc. 2020 Jul 23;30:100586. doi: 
      10.1016/j.ijcha.2020.100586. eCollection 2020 Oct.