Objective: To investigate the frequency, diagnosis and outcome of patients admitted to hospital with acute coronary syndrome (ACS) or other conditions associated with raised levels of cardiac troponin T.
Design: Observational study.
Setting: A large university hospital.
Patients: Consecutive patients admitted over an 8-week period who had a serum troponin T test as part of their clinical assessment were included. Patients were separated into those with raised (⩾0.01 μg/l) or normal (<0.01 μg/l) troponin T levels, and further categorised into those with or without a diagnosis of ACS.
Main outcome measures: In-hospital mortality in all patients; and 6-month hospital re-admissions and all-cause mortality in patients without or with ACS and raised levels of troponin T.
Results: Of 1021 patients, 118 patients had no ACS but raised troponin T levels, 195 had ACS with raised troponin T, 80 had ACS with normal troponin T and 628 had no ACS with normal troponin T. Their in-hospital all-cause mortalities were 36%, 18%, 0% and 3%, respectively (p<0.001, highest mortality v other groups). 6-month all-cause mortality remained higher in patients without ACS and with raised levels of troponin T than in those with ACS and raised troponin T (42% v 29%; p = 0.020).
Conclusions: Patients without ACS but with raised levels of troponin T comprised 38% of all hospitalised patients found to have raised troponin T. These patients had worse in-hospital and 6-month outcome than those having ACS with raised levels of troponin T.
- ACS, acute coronary syndrome
- acute coronary syndrome
- without acute coronary syndrome
- raised troponin T
- all-cause mortality
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Competing interests: PW received an unconditional research grant for the study from Bristol–Myers Squibb and Sanofi–Aventis Pharmaceuticals.
The Sefton Local Research Ethics Committee approved the study.
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