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

• Published in: The American journal of emergency medicine Vol. 17; no. 3; pp. 225 - 229
• Main Authors: Khan, Ijaz A, Tun, Aung, Wattanasauwan, Norrapol, Win, Moe T, Hla, Tin A, Hussain, Akhtar, Vasavada, Balendu C, Sacchi, Terrence J
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.05.1999; Elsevier
• Subjects: acute coronary syndromes; Acute Disease; Aged; AIDS/HIV; Biological and medical sciences; Biomarkers - blood; Cardiac troponin I; Cardiology. Vascular system; chronic renal failure; Coronary heart disease; Female; Heart; Heart Diseases - diagnosis; HIV disease; Humans; Male; Medical sciences; Middle Aged; muscular disorders; myocardial infarction; Myocardial Ischemia - diagnosis; Myocardial Ischemia - physiopathology; Myocardium - chemistry; neurological disorders; noncardiac diseases; nonischemic cardiomyopathy; Reference Values; Sensitivity and Specificity; sepsis; Troponin I - blood; unstable angina; Cardiac troponin I; noncardiac diseases; chronic renal failure; myocardial infarction; neurological disorders; HIV disease; nonischemic cardiomyopathy; unstable angina; acute coronary syndromes; sepsis; muscular disorders; Human; Troponin; Biological marker; Cardiovascular disease; Serum; Diagnosis; Coronary heart disease
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/S0735-6757(99)90110-9

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 sydromes 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.