Observational studyAnnals of medicine2022
Clinical implications of cardiac troponin-I in patients with hypertensive crisis visiting the emergency department.
Observational study in Annals of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- Article
- Characterizing myocardial edema and fibrosis in hypertensive crisis with cardiovascular magnetic resonance imaging.Scientific reports · 2024Article
- Simultaneous occurrence of transient global amnesia and Takotsubo syndrome triggered by caring for a terminally ill relative.Clinical case reports · 2024Article
- Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing.Diagnostics (Basel, Switzerland) · 2024Review
- Clinical Review of Hypertensive Acute Heart Failure.Medicina (Kaunas, Lithuania) · 2024Review
- Myocardial Tissue Characterization in Patients with Hypertensive Crisis, Positive Troponin, and Unobstructed Coronary Arteries: A Cardiovascular Magnetic Resonance-Based Study.Diagnostics (Basel, Switzerland) · 2023Article
- Association between D-dimer and long-term mortality in patients with acute severe hypertension visiting the emergency department.Clinical hypertension · 2023Article
- The Role of Cardiac Biomarkers in the Diagnosis of Hypertensive Emergency.Diagnostics (Basel, Switzerland) · 2023Article
- Prevalence of Myocardial Injury and Myocardial Infarction in Patients with a Hypertensive Emergency: A Systematic Review.Diagnostics (Basel, Switzerland) · 2022Review
- Association of anaemia with long-term mortality among patients with hypertensive crisis in the emergency department.Annals of medicine · 2022Article
- Cardiac Complications of Hypertensive Emergency: Classification, Diagnosis and Management Challenges.Journal of cardiovascular development and disease · 2022Review
- Relevance of Troponin I Elevation among Individuals with Hypertensive Emergency.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Association of Dipstick Proteinuria with Long-Term Mortality among Patients with Hypertensive Crisis in the Emergency Department.Journal of personalized medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCardiac troponin-I (cTnI) is a representative marker of myocardial injury. Elevation of cTnI is frequently observed in patients with hypertensive crisis, but few studies have examined its prognostic significance in hypertensive crisis. We aimed to determine whether cTnI could predict all-cause mortality in patients with hypertensive crisis visiting the emergency department (ED).
methodsThis observational study included patients aged ≥18 years who visited an ED between 2016 and 2019 for hypertensive crisis, defined as systolic blood pressure (BP) ≥180 mmHg and/or diastolic BP ≥110 mmHg. Among 6467 patients, 3938 who underwent a cTnI assay were analysed.
resultsAmong the 3938 patients, 596 (15.1%) had cTnI levels above the 99th percentile upper reference limit (elevated cTnI >40 ng/L) and 600 (15.2%) had cTnI levels between the detection limit (≥10 ng/L) and the 99th percentile upper reference limit (detectable cTnI). The 3-year all-cause mortality in the elevated, detectable and undetectable cTnI groups were 41.6%, 36.5% and 12.8%, respectively. After adjusting for confounding variables, elevated cTnI patients (adjusted hazard ratio [HR], 2.01; 95% confidence interval [CI], 1.61-2.52) and detectable cTnI patients (adjusted HR, 1.64; 95% CI, 1.32-2.04) showed a significantly higher risk of 3-year all-cause mortality than did patients with undetectable cTnI.
conclusionsIn patients with hypertensive crisis, elevated cTnI levels provide useful prognostic information and permit the early identification of patients with an increased risk of death. Moreover, putatively normal but detectable cTnI levels also significantly correlated with a higher risk of all-cause mortality. Intensive treatment and follow-up strategies are needed for patients with hypertensive crisis with elevated and detectable cTnI levels.Key messagesCardiac troponin-I level was an independent prognostic factor for all-cause mortality in patients with hypertensive crisis.Detectable but normal range cardiac troponin-I, which was considered clinically insignificant, also had a prognostic impact on all-cause mortality comparable to elevated cardiac troponin-I levels.
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