Elevation of serum cardiac troponin I in noncardiac and cardiac diseases other than acute coronary syndromes.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Elevation of serum cardiac troponin I in noncardiac and cardiac diseases other than acute coronary syndromes.

Am J Emerg Med. 1999 May;17(3):225-9. Unique Identifier : AIDSLINE MED/99268197
Khan IA; Tun A; Wattanasauwan N; Win MT; Hla TA; Hussain A; Vasavada BC; Sacchi TJ; Department of Medicine, Long Island College Hospital, Brooklyn,; NY, USA.

Abstract: This study evaluated the role of serum cardiac troponin I as a biochemical marker for the diagnosis of acute coronary syndromes in the presence of noncardiac diseases. Diagnostic characteristics were examined in 102 consecutive patients who were found to have serum cardiac troponin I levels higher than the upper reference limit of 0.6 ng/mL. Of 102 patients with cardiac troponin I levels of >0.6 ng/mL, 35 did not have the final diagnoses of acute coronary syndromes (myocardial infarction or unstable angina) but had various other final diagnoses, including nonischemic dilated cardiomyopathy, muscular disorders, central nervous system disorders, HIV disease, chronic renal failure, sepsis, lung diseases, and endocrine disorders. The mean value of serum cardiac troponin I in the patients with diseases other than acute coronary syndromes was significantly lesser than in those with acute coronary syndromes (2.0+/-1.9 [SD] v. 24.7+/-28.2 ng/mL; P<.0001). There were significantly fewer histories of chest pain and prior myocardial infarction in patients with diseases other than acute coronary syndromes than in those with acute coronary syndromes (history of chest pain, 3 v. 48 patients [P<.001]; history of prior myocardial infarction, 0 v. 30 patients [P<.001]). In conclusion, elevated serum levels of cardiac troponin I, especially in the lower ranges, should be interpreted with caution, particularly in patients suffering from acute illnesses who lack other diagnostic features suggestive of acute coronary ischemic events.

Keywords: JOURNAL ARTICLE Acute Disease Aged Biological Markers/BLOOD Female Heart Diseases/*DIAGNOSIS Human Male Middle Age Myocardial Ischemia/DIAGNOSIS/PHYSIOPATHOLOGY Myocardium/*CHEMISTRY Reference Values Sensitivity and Specificity Troponin I/*BLOOD
990830
A9981024

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