Prognostic value of initial elevation in cardiac troponin I level in critically ill patients without acute coronary syndrome.

Background: Cardiac troponin I levels are often obtained to help rule out acute coronary syndrome.

Objective: To determine if elevation of troponin level within 24 hours for patients without acute coronary syndrome admitted to the intensive care unit provides important prognostic information.

Methods: Patients without acute coronary syndrome admitted to the intensive care unit were prospectively divided into 2 groups according to highest serum level of cardiac troponin I within 24 hours of admission (elevated > 0.049 ng/mL; control ≤ 0.049 ng/mL). Hospital mortality, incidence of intubation, and other parameters were compared between the 2 groups.

Results: Patients with elevated troponin level (n = 40) had higher mortality than did control patients (n = 50) (35% vs 12%; P= .01). Compared with control patients, patients with elevated levels were more likely to be intubated (41% vs 17%; P= .02).

Conclusion: Critically ill patients without acute coronary syndrome with elevated levels of cardiac troponin I at admission had higher mortality and more intubations than did control patients.