Evidence map›Paper›PMID 28906388›Full record

ArticleMedicine2017

Retrospective cause analysis of troponin I elevation in non-CAD patients: Special emphasis on sepsis.

Chien-Wen Yang, Huijun Li, Lisa Thomas, Manuel Ramos, Po-Hong Liu, Thomas Roe, Ravinder Valadri, Michael C Kiel, Vincent Yi-Fong Su, Qi Shi

Open access · goldAbstract read
In one paragraph

Article in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Elevated Cardiac Troponin in Clinical Scenarios Beyond Obstructive Coronary Artery Disease.Medical science monitor : international medical journal of experimental and clinical research · 2019
    Pooled it
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 3 countries.

Chien-Wen YangDepartment of Internal Medicine, The Wright Center for Graduate Medical Education (WCGME), Scranton Hematology & Oncology Associates of Northeast Pennsylvania Department of Epidemiology, Harvard T.H. Chan School of Public Health Commonwealth Health Physician Network Great Valley Cardiology Department of Family Medicine, WCGME Department of Science, Marywood University, Scranton, PA Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
Huijun Li
Lisa Thomas
Manuel Ramos
Po-Hong Liu
Thomas Roe
Ravinder Valadri
Michael C Kiel
Vincent Yi-Fong Su
Qi Shi
The Wright Center for Graduate Medical Education · USHarvard University · USHematology and Oncology Associates of Northeastern Pennsylvania · USKangmei Pharmaceutical (China) · CNMarywood University · USNational Yang Ming Chiao Tung University · TWValley Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTroponin I is one of the most commonly tested biochemical markers in the emergency room (ER) and in the hospital setting. Besides coronary artery disease (CAD), demand ischemia with underlying tachycardia, anemia, hypertensive emergency, congestive heart failure, kidney disease, sepsis, and pulmonary embolism have also been reported to cause troponin I elevations. Few reports have excluded patients with CAD, and no study has summarized the proportion of these factors relative to an increased troponin I level.

methodsThe aim of this retrospective study was to investigate the level of contribution of causative factors in troponin I elevation. Charts of patients tested for troponin I during an ER visit or during hospitalization were collected. Patients with known CAD, abnormal stress tests, cardiac catheterizations, or discharge without an adequate cardiac evaluation were excluded. Logistic regression was used to identify predictors of elevated troponin I levels.

resultsA total of 586 patients were investigated in this study. Age, hemoglobin (Hb), heart rate (HR), glomerularfiltration rate, atrial fibrillation, congestive heart failure (CHF), and sepsis were significant predictors of elevated troponin I by analysis in univariate logistic regression (all P < .001). In multivariate logistic regression, sepsis, CHF, age, Hb, and HR were independent predictors of troponin I (all P < .01). A simple clinical scoring system was generated with 1 score on patients with age ≥ 60, Hb < 10 g/dL, and HR ≥ 100 beats per minute (bpm). The prevalence of elevated troponin I was 4%, 16%, 38%, and 50% for patients with scores of 0, 1, 2, and 3, respectively. In patients without sepsis and CHF, the chances of elevated troponin I were 2%, 11%, 28%, and 43%.

conclusionsSepsis was found to be the strongest independent cause of elevated troponin I levels in non-CAD patients. The scoring system composed of age, hemoglobin (Hb), and heart rate (HR) can assist clinical evaluation of elevated troponin I test in non-CAD patients.

Indexed as

AdultAgedAged, 80 and overCoronary Artery DiseaseFemaleHeart DiseasesHumansMaleMiddle AgedRetrospective StudiesSepsisTroponin ITroponin I

Identifiers

PMID28906388
PMCPMC5604657
OpenAlexW2755371351

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.