Evidence map›Paper›PMID 34792185›Full record

ArticleJournal of the American Geriatrics Society2022

Accounting for frailty and multimorbidity when interpreting high-sensitivity troponin I tests in oldest old.

Andrea Ticinesi, Antonio Nouvenne, Nicoletta Cerundolo, Beatrice Prati, Alberto Parise, Claudio Tana, Martina Rendo, Angela Guerra, Tiziana Meschi

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. High-sensitivity cardiac troponin I and frailty: associations with the frailty index and Fried phenotype in older women.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026
    Article
  2. Review
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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

9 authors at 4 institutions in 1 country.

Andrea TicinesiDepartment of Medicine and Surgery, University of Parma, Parma, Italy.ORCID 0000-0001-9171-8592
Antonio NouvenneGeriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Nicoletta CerundoloGeriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Beatrice PratiGeriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Alberto PariseGeriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Claudio TanaInternal Medicine Unit and Geriatrics Clinic, SS Annunziata Hospital, Chieti, Italy.
Martina RendoPrimary Care Department, Parma District, Azienda Unità Sanitaria Locale di Parma, Parma, Italy.
Angela GuerraDepartment of Medicine and Surgery, University of Parma, Parma, Italy.
Tiziana MeschiDepartment of Medicine and Surgery, University of Parma, Parma, Italy.
Ospedale di Parma · ITUniversity of Parma · ITAzienda Unita' Sanitaria Locale di Parma · ITOspedale SS. Annunziata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder patients evaluated in Emergency Departments (ED) for suspect Myocardial Infarction (MI) frequently exhibit unspecific elevations of serum high-sensitivity troponin I (hs-TnI), making interpretation particularly challenging for emergency physicians. The aim of this longitudinal study was to identify the interaction of multimorbidity and frailty with hs-TnI levels in older patients seeking emergency care.

methodsA group of patients aged≥75 with suspected MI was enrolled in our acute geriatric ward immediately after ED visit. Multimorbidity and frailty were measured with Cumulative Illness Rating Scale (CIRS) and Clinical Frailty Scale (CFS), respectively. The association of hs-TnI with MI (main endpoint) was assessed by calculation of the Area Under the Receiver-Operating Characteristic Curve (AUROC), deriving population-specific cut-offs with Youden test. The factors associated with hs-TnI categories, including MI, CFS and CIRS, were determined with stepwise multinomial logistic regression. The association of hs-TnI with 3-month mortality (secondary endpoint) was also investigated with stepwise logistic regression.

resultsAmong 268 participants (147 F, median age 85, IQR 80-89), hs-TnI elevation was found in 191 cases (71%, median 23 ng/L, IQR 11-65), but MI was present in only 12 cases (4.5%). hs-TnI was significantly associated with MI (AUROC 0.751, 95% CI 0.580-0.922, p = 0.003), with an optimal cut-off of 141 ng/L. hs-TnI levels ≥141 ng/L were significantly associated with CFS (OR 1.58, 95% CI 1.15-2.18, p = 0.005), while levels <141 ng/L were associated with the cardiac subscore of CIRS (OR 1.36, 95% CI 1.07-1.71, p = 0.011). CFS, but not hs-TnI levels, predicted 3-month mortality.

conclusionsIn geriatric patients with suspected MI, frailty and cardiovascular multimorbidity should be carefully considered when interpreting emergency hs-TnI testing.

Indexed as

FrailtyMultimorbidityRisk AssessmentAged, 80 and overBiomarkersFemaleHospitalizationHumansLongitudinal StudiesMaleMyocardial InfarctionTime FactorsTroponin IBiomarkersTroponin Iacute coronary syndromecomorbiditydisabilitygeriatric cardiologyoldest old

Identifiers

PMID34792185
PMCPMC9299120
OpenAlexW3212311326

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.