Abstract 9459: Cardiac Troponin I and the Risk of Cardiovascular or Non-Cardiovascular Death in Patients Visiting Emergency Department

Abstract

Background: To identify the magnitude and temporal relationship between cardiac troponin I (TnI) and the risk of cardiac or non-cardiac death. Methods: Consecutive patients were included with maximal TnI value within 24 hours of their emergency department visit. Multivariate analyses using parameters selected by Bayesian information criterion was performed to investigate the impact of TnI on the event rate, time-dependent risk, and dose-dependent risk of cardiac or non-cardiac death within 360 days. We investigated the association between cardiac troponin I (TnI) and the risk of cardiac or non-cardiac death according to period. Results: A total of 36806 patients were included. There were 5,472 (14.9%) all-cause deaths including 881 (2.4%) cardiac and 4,591 (12.5%) non-cardiac deaths. In patients with positive TnI defined as the ≥99 th percentile of upper normal limit, the cumulative risk of cardiac and non-cardiac death were 4.4- and 1.4- fold higher compared to negative TnI, respectively. In competing risk analysis, positive TnI was linked to 2.4- and 1.2-fold higher risks of cardiac and non-cardiac death, respectively. TnI value showed positive relationship with the risk of both cardiac and non-cardiac death. In time-dependent risk analysis, the excess risk of cardiac death was concentrated in early few weeks. Conclusions: Even a small increase in TnI was associated with increased risk of both cardiac and non-cardiac death, which was concentrated in the early period after emergency department visit.