Prognostic value of initial elevation in cardiac troponin I level in critically ill patients without acute coronary syndrome

Abstract

BACKGROUND: Cardiac troponin I levels are often obtained to help rule out acute coronary syndrome. OBJECTIVE To determine if elevation of troponin level within 24 hours for patients without acute coronary syndrome admitted to the intensive care unit provides important prognostic information. METHODS: Patients without acute coronary syndrome admitted to the intensive care unit were prospectively divided into 2 groups according to highest serum level of cardiac troponin I within 24 hours of admission (elevated > 0.049 ng/mL; control ≤ 0.049 ng/mL). Hospital mortality, incidence of intubation, and other parameters were compared between the 2 groups. RESULTS: Patients with elevated troponin level (n = 40) had higher mortality than did control patients (n = 50) (35% vs 12%; P= .01). Compared with control patients, patients with elevated levels were more likely to be intubated (41% vs 17%; P= .02). CONCLUSION: Critically ill patients without acute coronary syndrome with elevated levels of cardiac troponin I at admission had higher mortality and more intubations than did control patients.