Association Between All-Cause Mortality and High-Sensitivity Cardiac Troponin Concentrations in Patients With Chest Pain.

Abstract

We assessed the association between troponin levels and all-cause mortality in individuals with chest pain who presented to the Charleston Area Medical Center Emergency Department (CAMC). We identified adult patients with chest pain as defined in the International Classification of Diseases 10 (R07) family group from the CAMC data warehouse between June 6, 2020, and June 6, 2021. These cases required a visit to the emergency room. We created 3 different cohorts to assess the endpoints of all-cause mortality at 30days and 6months. Patients were divided into the following 3 categories: negative troponin level, defined as high sensitivity troponin I (HSTNI) assay ≤15pg/mL for women and ≤20pg/mL for men; weakly positive, 21-88pg/mL for men and 16-88pg/mL for women; and strongly positive, >88pg/mL for men and women. A propensity score matching analysis was also conducted using the negative group as a control; the weakly and strongly positive groups were compared to the control across differing cardiology covariates. This study introduces novel cutoffs for high-sensitivity troponin I (Beckman Coulter assay, Beckman Coulter, Inc., Chaska Campus, 1000 Lake Hazeltine Drive, Chaska, Minnesota 55318).