Is high sensitivity troponin, taken regardless of a clinical indication, associated with 1 year mortality in critical care patients?

Hinton, Jonathan; Augustine, Maclyn; Gabara, Lavinia; Mariathas, Mark; Allan, Rick; Borca, Florina; Nicholas, Zoe; Gillett, Neil; Kwok, Chun Shing; Cook, Paul; Grocott, Michael PW; Mamas, Mamas; Curzen, Nick

Abstract

The aim of this study was to assess whether high sensitivity troponin (hs-cTnI) is associated with 1 year mortality in critical care (CC). One year mortality data were obtained from NHS Digital for a consecutive cohort of patients admitted to general CC unit (GCCU) and neuroscience CC unit (NCCU) who had hs-cTnI tests performed throughout their CC admission, regardless of whether the test was clinically indicated. Cox proportional hazards were used to estimate the risk of 1-year mortality. A landmark analysis was undertaken to assess whether any relationship at 1 year was driven by mortality within the first 30 days. A total of 1033 consecutive patients were included. At 1 year 254 (24.6%) patients had died. The admission log(10)hs-cTnI concentration in the entire cohort (HR 1.35 (95% CI 1.05–1.75) p = 0.009 with a bootstrap of 1000 samples) was independently associated with 1 year mortality. On landmark analysis the association with 1 year mortality was driven by 30 day mortality. These results indicate that admission hs-cTnI concentration is independently associated with 1 year mortality in CC and this relationship may be driven by differences in mortality at 30 days.

Citation

Hinton, J., Augustine, M., Gabara, L., Mariathas, M., Allan, R., Borca, F., …Curzen, N. (2023). Is high sensitivity troponin, taken regardless of a clinical indication, associated with 1 year mortality in critical care patients?. Journal of the Intensive Care Society, 24(4), 392-398. https://doi.org/10.1177/17511437231160078

• Journal Article Type: Article
• Acceptance Date: Apr 30, 2023
• Online Publication Date: Mar 30, 2023
• Publication Date: Mar 30, 2023
• Journal: Journal of the Intensive Care Society
• Print ISSN: 1751-1437
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 4
• Pages: 392-398
• DOI: https://doi.org/10.1177/17511437231160078
• Keywords: High sensitivity troponin; myocardial infarction; critical care
• Publisher URL: https://journals.sagepub.com/doi/10.1177/17511437231160078