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To analyze the disease spectrum of high-sensitive cardiac troponin I (hs-cTnI)-positive patients and to provide guidance for clinical practice.
Data of 1017 inpatients receiving continuous hs-cTnI test from August 2012 to November 2013 were retrospectively collected. Patients were grouped based on age (<60, 60-69, 70-79, and >80 years) and estimated glomerular filtration rate (normal renal function, mild renal insufficiency, moderate renal insufficiency, and severe renal insufficiency). Differences in disease spectrum were analyzed.
Of the hs-cTnI-positive patients, 51.7% had acute coronary syndrome (ACS), whereas 48.3% did not. ST segment elevation myocardial infarction had the highest incidence (28.2%), followed by arrhythmia (23.3%), non-ST segment elevation myocardial infarction (17.4%), heart failure (17.0%), and sepsis (9.0%).
On analyzing the disease spectrum by age groups, the 5 most common diseases among hs-cTnI-positive patients above 60 years were the same as in all other groups; among patients below 60 years, the spectrum additionally included myocardial infarction, heart failure, arrhythmia, and myocarditis. Non-ACS patients below 60 years exhibited sepsis, severe trauma, post cardiopulmonary resuscitation and subarachnoid hemorrhage, and those above 60 years exhibited sepsis, chronic renal failure, gastrointestinal bleeding and stroke.
The 5 most common diseases in the severe renal insufficiency group were heart failure, arrhythmia, non-ST segment elevation myocardial infarction, sepsis, and ST segment elevation myocardial infarction.
ACS accounted for approximately half of the positive hs-cTnI spectrum; non-ACS caused hs-cTnI elevation was also common. Age and renal function affect the hs-cTnI spectrum and should be considered along with history, symptoms, signs and laboratory test results in clinical evaluation.