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. 2024 Dec 20;24(1):719.
doi: 10.1186/s12872-024-04388-8.

Troponin-T as predictor of mortality in patients attending the emergency department with atrial fibrillation

Serkan Celik  1 , Linus Bodeström Eriksson  2 , Jakob Hytting  2 , Annette Waldemar  2 , Panagiotis Mallios  2 , Amanda Berggren  2 , Ellen Oscarsson  2 , Christofer Digerfeldt  2 , Magnus Wijkman  3 , Laila Hubbert  2
Affiliations

Troponin-T as predictor of mortality in patients attending the emergency department with atrial fibrillation

Serkan Celik et al. BMC Cardiovasc Disord. .

Abstract

Background: High-sensitive Troponin-T (hsTnT) is often increased in acute illness and may be of prognostic importance in patients with atrial fibrillation (AF). The aim of this study was to analyse the characteristics and data of patients attending the emergency department (ED) with AF to determine whether age-adjusted hsTnT levels can predict mortality.

Methods: This retrospective, single centre, register-based cohort study included all patients ≥ 18 years attending the emergency department during 2018 and 2020 with a primary diagnosis at the ED of AF and sampled for hsTnT. Symptoms, comorbidities, lab results, and characteristics were registered. Patients were divided into groups based on hsTnT level (< 15, 15-50, and > 50 ng/L).

Primary outcomes: 30-day and 1-year mortality.

Results: A total of 625 patients were included (median age 72, and 45% female). All-cause mortality was 2% at 30 days and 8% at 1-year. The hazard ratio (HR) for 30-day mortality was 4.17 (95% confidence interval (CI) 0.49-35.79, p = 0.192) for hsTnT 15-50 ng/L and 9.64 (95% CI 0.98-95.30, p = 0.053) for hsTnT > 50 ng/L compared to hsTnT < 15 ng/L when adjusted for age. The HR for 1-year mortality was 4.82 (95% CI 1.81-12.82, p = 0.002) for hsTnT 15-50 ng/L and 9.70 (95% CI 3.27-28.74, p < 0.001) for hsTnT > 50 ng/L compared to hsTnT < 15 ng/L when adjusted for age.

Conclusions: Elevated hsTnT levels increase the risk for 30-day and 1-year mortality independently of age. Both mild and major elevation of hsTnT levels is associated with increased risk for 1-year mortality regardless of age.

Keywords: Atrial fibrillation; Emergency department; Mortality; Troponin-T.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Swedish Ethics Review Authority (2021-05963-01) and permission was obtained to access and use the registries and medical records. Based on Swedish data legislation, a patient registered in a quality register does not need to provide written informed consent for their data to be included in healthcare register research. They are informed that their data are included in the register and that these may be removed at any time if so desired. Consent for publication: Under Swedish data legislation, a patient registered in a health register is not required to provide written informed consent for their data to be included in a published article. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of patients at the emergency department. The relative (%) multiple sampling taken was calculated from the number of patients admitted
Fig. 2
Fig. 2
Kaplan-Meier curves and number at risk illustrating 1-year mortality for different Troponin-T levels. TnT = High-sensitive Troponin-T
See this image and copyright information in PMC

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