Troponin

Diagnoses and mortality in a population without acute myocardial infarction, but with elevated highsensitive troponin I – a retrospective register-based single center study

Original Articles, Volume 20, Issue 1, Pages 1-88 (2021)

Aim: To explore, which differential diagnoses to consider in individuals with elevated troponins without acute myocardial infarction (AMI), and the mortality for those individuals.

Methods: Retrospective, register-based study on a representative sample of the Danish population with the following inclusion criteria: High-sensitive troponin I (hs-TnI) ≥25 ng/L, age ≥18 years, and exclusion of AMI.

Results: 3067 individuals without AMI but increased hs-TnI were included. Most frequent discharge diagnoses: Pneumonia (12.8%), Aortic valve disorder (11.3%), Medical observation (10.9%) and Heart failure (8.9%). The 30-days and one-year mortality was 15.8% and 32.0%, respectively.

Conclusions: A selected number of alternative diagnoses must be considered in individuals with increased hs-TnI. Due to high mortality it is crucial to carefully evaluate these individuals despite the absence of AMI.

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Non-Cardiac Chest Pain: management in the Ambulatory Clinic setting

Clinical Reviews, Volume 18, Issue 3, Pages 137 – 204 (2019)

Non-cardiac chest pain (NCCP) is a common presenting complaint which can be better managed. This requires the recognition of clinical sub-groups with investigation and treatment tailored accordingly. The aim of this paper is to encourage more accurate diagnoses and the better recognition of the source of chest pain. We discuss the appropriate investigations and management of each clinical sub-group.

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Viewpoint: Management of the patient with an ‘incidentally’ raised troponin

Viewpoint, Volume 10, Issue 3, Pages 121 - 172 (2011)

Abstract

Troponin assays are a valuable tool in early risk stratification of patients with ischaemic sounding chest pain. However, troponin is often measured outside of this clinical context. The finding of a raised troponin value may be misinterpreted as an acute coronary syndrome leading to unnecessary and sometimes dangerous anticoagulation. This article looks at some of the considerations which need to be made when interpreting the significance of a raised troponin value.

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