ArticleCritical pathways in cardiology2026
Maximum Troponin As an Independent Predictor of 30- and 90-day Mortality in Type 2 Myocardial Infarction.
Article in Critical pathways in cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundType 2 myocardial infarction (Type 2 MI) is increasingly recognized among older adults and individuals with multiple comorbidities. We evaluated the association between maximum troponin levels and 30- and 90-day all-cause mortality using both continuous values and clinically meaningful thresholds.
methodsWe conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV database. Our analysis focused on patients with Type 2 MI, with maximum troponin level being the primary exposure of interest. We examined troponin's association with both 30-day and 90-day mortality, treating it as a continuous variable and categorizing it into thresholds: 10×, 100×, and 1000× the upper limit of normal (ULN), using 0.04 ng/mL (99th percentile of ULN) as the reference group. 1398 patients met our inclusion criteria.
resultsMaximum troponin was an independent predictor of 30-day mortality and 90-day mortality after adjusting for confounders ( P = 0.018, P = 0.016, respectively). Compared with the reference group (<0.04 ng/mL), the relative risks of 30-day mortality were 1.39 [95% confidence intervals (CI), 0.89-2.17] for 10× ULN, 1.72 (95% CI, 1.10-2.71) for 10-100× ULN, 1.85 (95% CI, 1.16-2.95) for 100-1000× ULN, and 2.45 (95% CI, 1.31-4.57) for >1000× ULN. A similar pattern was seen for 90-day mortality, with relative risks of 1.28 (95% CI, 0.89-1.96), 1.76 (95% CI, 1.22-2.69), 1.63 (95% CI, 1.09-2.54), and 2.07 (95% CI, 1.05-3.35), respectively.
conclusionsHigher troponin levels are independently associated with increased short- and intermediate-term mortality in Type 2 MI, supporting the potential use of troponin thresholds for risk stratification in this high-risk population.
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