Researchers have found that patients with low high-sensitivity cardiac troponin T levels in emergency departments (ED) may have comparable long-term survival rates to the general population.
In a study published in Heart, the researchers used the data from seven Swedish EDs to analyze the long-term prognosis of 111,916 patients visiting EDs with chest pain and low high-sensitivity cardiac troponin T (hs-cTnT) levels compared with the general population between December 2010 and August 2017. Patients with myocardial injury, including myocardial infarction, were excluded. The study focused on patients with undetectable (< 5 ng/L) and low (5–14 ng/L) hs-cTnT levels. The primary outcomes measured were all-cause mortality and major adverse cardiovascular events (MACE), including acute myocardial infarction, heart failure hospitalizations, cerebrovascular stroke, or cardiovascular death.
Patients with undetectable high-sensitivity cardiac troponin T levels had a 17% lower risk of mortality compared with the general population (standardized mortality ratio = 0.83, 95% confidence interval [CI] = 0.79–0.87).
The researchers discovered that the patients with undetectable hs-cTnT levels exhibited a slightly higher risk of future myocardial infarction (standardized incidence ratio [SIR] = 1.39, 95% confidence interval [CI] = 1.32–1.47). In contrast, there were no statistically significant differences in mortality risk between patients with low hs-cTnT levels and those in the general population (standardized mortality ratio = 1.02, 95% CI = 0.99–1.05). However, patients with low hs-cTnT levels had a 56% higher risk of myocardial infarction (SIR =1.56, 95% CI = 1.50–1.62).
The adjusted risk of a first MACE was 1.6 times higher in patients with low hs-cTnT compared with those with undetectable levels (hazard ratio = 1.61, 95% CI = 1.53–1.70).
The researchers found that patients with undetectable hs-cTnT levels had a lower mortality risk, whereas detectable hs-cTnT levels were linked to increased long-term cardiovascular risks.
The authors reported on potential conflict of interest.