Troponin Elevation in Patients Without Acute Coronary Syndrome

Outcomes with type 2 myocardial infarction compared with non-ischaemic myocardial injury

“…Of particular note is our finding that patients with type 2 MI and patients with NIMI have similar mortality and readmission rates for heart failure during the 2-year follow-up and, moreover, these events occurred more frequently than in patients with type 1 MI; for patients with type 2 MI, this worse prognosis is similar to that described by Saaby26 and it could be explained by the conjunction of several factors which include advanced age and increased presence of comorbidities despite having lower levels of troponin; the worse prognosis is also related to the elevation of TnI, as has been evidenced by Bardají et al ,13 and it is also possible that the excess of mortality in this population is determined by the underlying disease. In contrast, readmission rates for ACS during the follow-up of patients diagnosed with type 2 MI and NIMI are lower than those for patients with type 1 MI, which suggests that a high proportion of these patients do not present with significant coronary lesions,27 28 a finding that should be investigated in future studies.…”

“…The continuous technical refinement of laboratory troponin measurement brought about this test as an ideal biomarker for early detection of MI and this has favoured a progressive increase in the number of patients with high troponin levels presenting with acute or chronic clinical conditions other than ACS 13. This heterogeneous clinical scenario led to a review of the classical diagnostic criteria of MI.…”

Prognostic implications of troponin I elevation in emergency department patients with tachyarrhythmia

“…However, elevated cTnI levels are frequently encountered in various clinical situations, such as pulmonary thromboembolism, HF, and sepsis and is associated with poor prognosis . In previous studies, it has been shown that a high proportion of patients admitted to the ED present cTnI elevation in clinical contexts other than acute atherothrombotic plaque disruption (type 1 MI) and that this elevation is associated with a worse prognosis in follow‐ups . In addition, it has been observed that the prognosis was similar in patients who fulfill diagnostic criteria for type 2 MI and for non‐ischemic myocardial injury, being worse compared to patients with type 1 MI .…”

Elevated cardiac troponin T in cirrhotic patients with emergency care admissions: Associations with mortality

“…Among those, there were patients with end‐stage liver disease, sepsis, renal failure, stroke, and pulmonary embolism. Those studies concluded that troponin was a predictor of high mortality regardless of the final diagnosis . In critically ill septic patients, troponin release has been attributed to focal ischemia, massive sympathomimetic response, direct cardiac myocytotoxic effects of endotoxins, cytokines, or reactive oxygen species because of inflammatory processes .…”

“…Of a total of 237 cirrhotic ED patients, cTnT measurements were available for 87 (63% men, mean age 58.9 ± 11.0 years, and median Model for End‐stage Liver Disease score was 15 [25th–75th percentile: 10–19]). Chronic Liver Failure Consortium acute‐on‐chronic liver failure (CLIF‐C‐ACLF) score was 33 . Forty‐three patients (49%) had cTnT values above the normal range (14 ng/L), of which 19 (22%) had values over 30 ng/L.…”