The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

Abstract

Background: Several studies have linked elevated cardiac troponin to increased overall risk in patients with acute coronary syndrome but the prognostic significance of elevated troponin in non-cardiac conditions remains scanty. Objectives:The primary aim of this study was to investigate the prognostic significance of elevated high sensitivity troponin T (TnT-HS) in non-cardiac disorders outside the remit of an acute coronary syndrome (ACS). Secondarily we aimed to investigate the impact of cardiovascular comorbidities and other clinical presentations in the release of cardiac biomarkers in non-cardiac disorders.Methodology: This was a retrospective electronic patient record pilot review where all patients with elevated TnT-HS without acute coronary syndrome, recent angioplasty or heart failure within a three month period were enrolled into the study and subsequently followed prospectively for a six month period. From January 1, 2016 to June 30, 2016, a total of 2535 patients were screened of which 306 patients had elevated TnT-HS and 162 patients met the study inclusion criteria.Data were encrypted and collected in Google database format, exported into excel spreadsheet, analyzed and computed using SPSS (version 24) to identify clinical associations with increased values of TnT-HS.Results: Most troponin TnT-HS samples (77.1%) were obtained from emergency room (ER) attendance and 63.4% of patients were male. The mean age was 72 years and no Conclusions: TnT-HS positivity should be cautiously interpreted in patients exhibiting non acute cardiac conditions associated CKD, infections, and CVAs. This troponin elevation in non-cardiac conditions still carries a significant adverse prognosis.After adjusting for age and renal insufficiency, we can suggest a new cut off level of TnT-HS > 30 ng/l to have increased risk of MACCE within 180 days in non-cardiac conditions.

Early echocardiographic findings in patients hospitalized for COVID-19 pneumonia: a prospective, single center study

“…Moreover, cardiac damage could be mediated by systemic cytokinine toxicity during the hyperinflammation stage, inducing an increase in troponin values [4,8]. However, troponin elevation in COVID-19 patients could represent the consequence of a more severe systemic disease, not necessarily being indicative of primary cardiac dysfunction [4,9]. Finally, the strict heart-lung interaction should be considered, in particular in the setting of the most severe cases of COVID pneumonia, where a right ventricle (RV) dysfunction has been reported [10].…”

Recent Advances in Engineering of 2D Materials‐Based Heterostructures for Electrochemical Energy Conversion

“…On the other hand, if electrons first couple with protons and then combine with the adsorbed hydrogen atoms in the first step (the Volmer reaction) to generate desorbed hydrogen, it is expressed as the Heyrovsky step. [138] In the Volmer reaction, the Tafel slope b = 2.3RT 𝛼F ≈ 120 mV, where R represents the ideal gas constant, T represents the absolute temperature, 𝛼 represents the symmetry coefficient of about 0.5, and F represents the Faraday constant. [139] In the Tafel reaction, the slope is b = 2.3RT (1+𝛼)F ≈ 40 mV, while in the Heyrovsky reaction, it is b = 2.3RT 2F ≈ 30 mV.…”