Etiology of Minor Troponin Elevations in Patients with Atrial Fibrillation at Emergency Department–Tropo-AF Study
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristic | TnT ≤ 14 ng/L (n = 795) | TnT 15–100 ng/L (n = 2116) | |
---|---|---|---|
No. (%) | No. (%) | p | |
Age, median (IQR), y | 72.0 (14) | 81.0 (12) | <0.001 |
Women | 431 (54.3) | 1026 (48.5) | 0.005 |
CHA2DS2-VASc, mean (SD) | 3.30 (1.85) | 4.11 (1.68) | <0.001 |
Heart failure | 86 (10.8) | 524 (24.8) | <0.001 |
Hypertension | 505 (63.5) | 1485 (70.2) | 0.001 |
Diabetes mellitus | 155 (19.5) | 590 (27.9) | <0.001 |
Prior stroke | 119 (15.0) | 346 (16.4) | 0.39 |
Prior myocardial infarction | 99 (12.5) | 350 (16.5) | 0.007 |
Hypercholesterolemia | 340 (42.8) | 811 (38.3) | 0.03 |
Coronary artery disease | 186 (23.4) | 683 (32.3) | <0.001 |
Heart rate at admission, median (IQR), bpm | 81 (66–102) | 87 (72–109) | <0.001 |
Systolic blood pressure, median (IQR), mm Hg * | 144 (126–163) | 140 (122–160) | 0.002 |
ST depression in admission ECG *,† | 42 (5.8) | 305 (15.9) | <0.001 |
Laboratory tests at admission | |||
TnT, median (IQR), ng/L | 9 (6–11) | 30 (21–48) | <0.001 |
Hemoglobin, median (IQR), g/dL | 13.8 (12.8–14.7) | 12.8 (11.5–14.2) | <0.001 |
Creatinine, median (IQR), μmol/L | 79.6 (70.7–97.2) | 97.2 (79.6–124) | <0.001 |
eGFR, median (IQR), mL/min/1.73 m2 | 71.3 (58.8–83.8) | 55.1 (40.0–72.3) | <0.001 |
ProBNP, median (IQR), ng/L * | 998 (454–2335) | 3370 (1580–6355) | <0.001 |
CRP, median (IQR), mg/L | 3 (2–7) | 10 (3–37) | <0.001 |
Univariable | Odds Ratio (95% CI) | p | Multivariable | Odds Ratio (95% CI) | p |
---|---|---|---|---|---|
Age ≥ 75 years | 3.89 (3.28–4.62) | <0.001 | Age ≥ 75 years | 4.77 (3.77–6.04) | <0.001 |
Male gender | 1.26 (1.07–1.49) | 0.005 | Male gender | 2.54 (2.01–3.21) | <0.001 |
Heart failure | 2.71 (2.13–3.47) | <0.001 | Chest pain | 0.58 (0.44–0.76) | <0.001 |
Hypertension | 1.35 (1.14–1.61) | 0.001 | ST depression in admission ECG * | 2.71 (1.85–3.97) | <0.001 |
Diabetes mellitus | 1.60 (1.31–1.95) | <0.001 | Ventricular rate ≥ 100 bpm at admission | 1.71 (1.36–2.17) | <0.001 |
Prior stroke or TIA | 0.98 (0.80–1.20) | 0.83 | eGFR < 45 mL/min/1.73 m2 | 5.06 (3.58–7.14) | <0.001 |
Hypercholesterolemia | 0.83 (0.71–0.98) | 0.03 | CRP ≥ 50 mg/L | 3.79 (2.49–5.77) | <0.001 |
Coronary artery disease | 1.56 (1.29–1.89) | <0.001 | Hemoglobin < 10.0 g/dL | 4.95 (2.33–10.55) | <0.001 |
Active malignancy | 1.30 (0.85–1.98) | 0.23 | |||
Chest pain | 0.44 (0.36–0.54) | <0.001 | |||
ST depression in admission ECG *,† | 3.06 (2.19–4.27) | <0.001 | |||
Ventricular rate ≥ 100 bpm at admission | 1.37 (1.14–1.64) | 0.001 | |||
AF at admission | 1.79 (1.51–2.12) | <0.001 | |||
eGFR < 45 mL/min/1.73 m2 | 6.40 (4.82–8.51) | <0.001 | |||
CRP ≥ 50 mg/L † | 5.04 (3.46–7.35) | <0.001 | |||
Hemoglobin < 10.0 g/dL | 6.19 (3.34–11.4) | <0.001 |
Univariable Predictors | Odds Ratio (95% CI) | p | Multivariable Predictors | Odds Ratio (95% CI) | p |
---|---|---|---|---|---|
Age ≥ 75 years | 0.88 (0.56–1.37) | 0.561 | Chest pain | 8.29 (5.20–13.2) | <0.001 |
Male gender | 1.73 (1.13–2.66) | 0.012 | Coronary artery disease | 2.33 (1.42–3.81) | 0.001 |
Hypertension | 1.43 (0.88–2.33) | 0.148 | eGFR < 45 mL/min/1.73 m2 * | 1.65 (1.04–2.63) | 0.035 |
Diabetes mellitus | 1.69 (1.11–2.59) | 0.015 | |||
Hypercholesterolemia | 2.52 (1.66–3.84) | <0.001 | |||
Prior myocardial infarction | 3.83 (2.50–5.87) | <0.001 | |||
Prior stroke or TIA | 0.67 (0.37–1.21) | 0.186 | |||
Coronary artery disease | 4.68 (3.01–7.26) | <0.001 | |||
Heart failure | 0.91 (0.56–1.48) | 0.711 | |||
Chest pain | 11.1 (7.19–17.1) | <0.001 | |||
eGFR < 45 mL/min/1.73 m2 | 1.57 (1.03–2.37) | 0.035 | |||
CRP ≥ 50 mg/L | 0.38 (0.18–0.80) | 0.009 | |||
Troponin T, ≥100% change | 1.86 (0.99–3.48) | 0.054 | |||
Hemoglobin < 100 g/L | 1.06 (0.51–2.23) | 0.873 | |||
ST depression in ECG * | 0.73 (0.37–1.43) | 0.355 |
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Jaakkola, S.; Paana, T.; Nuotio, I.; Kiviniemi, T.O.; Pouru, J.-P.; Porela, P.; Biancari, F.; Airaksinen, K.E.J. Etiology of Minor Troponin Elevations in Patients with Atrial Fibrillation at Emergency Department–Tropo-AF Study. J. Clin. Med. 2019, 8, 1963. https://doi.org/10.3390/jcm8111963
Jaakkola S, Paana T, Nuotio I, Kiviniemi TO, Pouru J-P, Porela P, Biancari F, Airaksinen KEJ. Etiology of Minor Troponin Elevations in Patients with Atrial Fibrillation at Emergency Department–Tropo-AF Study. Journal of Clinical Medicine. 2019; 8(11):1963. https://doi.org/10.3390/jcm8111963
Chicago/Turabian StyleJaakkola, Samuli, Tuomas Paana, Ilpo Nuotio, Tuomas O. Kiviniemi, Jussi-Pekka Pouru, Pekka Porela, Fausto Biancari, and K. E. Juhani Airaksinen. 2019. "Etiology of Minor Troponin Elevations in Patients with Atrial Fibrillation at Emergency Department–Tropo-AF Study" Journal of Clinical Medicine 8, no. 11: 1963. https://doi.org/10.3390/jcm8111963