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The availability of high-sensitivity cardiac troponin T (HS-cTnT) levels have make the diagnosis of myocardial injury easily diagnosed and treated. However, it is unknown to what extent non-cardiac causes, including renal dysfunction, may contribute to the level elevation.
In a retrospective single-centre study, we enrolled consecutive patients presenting with acute chest pain to the emergency department. Of 846 patients enrolled, 601 were adjudicated by 2 independent physicians to have a Non-cardiac cause of chest pain. Multivariate analyses were used to determine the important predictors of HS-cTnT and relative risk for mortality during the index admission.
The median level of HS-cTnT was 7.6 (IQR 32) ng/L. A total of 189 patients (31.4%) had elevated HS-cTnT of more than 16 ng/L or 34 ng/L for female and male respectively. Main presenting complaint that necessitate HS-cTnT level being investigated were chest pain, dyspnoea, fever and cough with 22.5%, 21.5% and 20.3% respectively. In increasing order of importance, smoking, infection, presenting complaint as chest pain and abnormal glomerular filtration rate, were the significant factors in linear regression analysis to predict elevated HS-cTnT. Overall patients with elevated HS-cTnT were at increased risk for All-cause mortality (relative risk 8.8; 95% confidence interval, 4.4-17.2; P<0.01) during index admission.
Significant predictor for elevation of HS-cTnT inpatients with non-cardiac chest pain are smoking, infection, presenting complaint as chest pain and abnormal glomerular filtration rate. Elevated HS-cTnT in these patients gave 8.8 times relative risk of index admission mortality.