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Troponin testing yields no clinical value

03 Oct 2017

Elevated troponin test results are mostly present in patients without chest pain or ischaemic electrocardiographic (ECG) changes, have no clinical utility and lead to downstream testing, a recent study has found.

Researchers enrolled patients (aged 30 to 100 years) hospitalized in cardiology and internal medicine departments from 1 July 2013 until 31 July 2016. They selected a subgroup of 723 consecutive patients with elevated troponin values for chart review to determine the proportion of participants without chest pain or ischaemic ECG changes, and resultant differential treatment and downstream testing.

Clinical utility referred to coronary artery interventions or treatment of life-threatening arrhythmias, according to researchers.

Of all hospitalized patients (n=31,448), 52.5 percent (n=16,519) received troponin measurements, and 29.9 percent (n=4,938) of these had elevated troponin values.

About two-thirds of the patients reviewed did not have chest pain or ischaemic ECG changes (63.3 percent). In addition, the elevated troponin values neither resulted in coronary artery interventions nor treatment of life-threatening arrhythmias.

The elevated troponin values were the sole cause of hospitalization in 2.0 percent (n=9), cardiac monitoring in 6.1 percent (n=28), cardiac consultations in 11.1 percent (n=51) and left heart catheterization in 0.7 percent (n=3) of patients.

In an earlier study of patients with chest pain anticipated to have a low prevalence of coronary artery disease (CAD) and a good prognosis, deFilippi and colleagues found that cardiac troponin T identified a subgroup with a high prevalence of extensive and complex CAD and elevated risk for long-term adverse outcomes. [J Am Coll Cardiol 2000;35:1827-34]

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Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
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