Key result
Each additional comorbidity significantly increased the odds of having high hs-cTnT levels (AOR 1.311), demonstrating a greater impact than each year of advancing age (AOR 1.073) in elderly patients without acute coronary syndrome.
Why the study?
Elevated hs-cTnT in the elderly has been viewed as an age-related phenomenon, raising questions about whether aging or comorbidities are the primary cause of increased levels without AMI.
Cohort (n=6,822)
No
Odds Ratio: 1.311 (95% CI 1.272–1.352)
p-value: p=<0.001
Elevated high-sensitivity cardiac Troponin T levels in elderly patients without acute coronary syndrome are primarily driven by the burden of comorbidities rather than advancing age itself.
Elevated hs-cTnT in elderly patients without AMI mainly reflects comorbidities; leaves open whether comorbidity-focused evaluation should guide interpretation.
High level of cardiac Troponin T (hs-cTnT) in geriatric population has been considered as an age-related phenomenon, which may question the interpretation of the increase of hs-cTnT in this population. The challenge is what is the primary cause of the increased hs-cTnT levels in elderly patients without AMI. Objective The aim of the current study was to determine the impact of aging on hs-cTnT levels in elderly patients without acute cardiac events but in the presence of comorbidities. Methods Sociodemographic and clinical data were collected from 6977 medical records of patients aged ≥65 years without acute coronary events but for whom hs-cTnT measurements were available. The patients were stratified based on age, troponin levels and the number of comorbidities. Results The results suggested that the likelihood of increased hs-cTnT was related to the presence of comorbidities independently of their number (p < 0.05). The adjusted odds ratio (AOR) for both advanced age and having comorbidity was statistically significant, however for the old group (74 ≥ age ≥ 84 years) the chance of having elevated troponin regarding age compared to the presence of comorbidity was 1.070 vs. 1.216, whereas for the old-old group (≥85 years) it was found to be 1.071 vs. 1.311. Besides statistical significance for age, from a clinical standpoint, the AOR of 1.070 may not be considered clinically relevant. Conclusion Increased hs-cTnT levels were associated with the presence of pre-existing comorbidities independently of age. Increased hs-cTnT levels in the elderly should always be considered as pathological, and a specific etiology should be searched.
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Sedighi et al. (2019) conducted a cohort in Elderly patients without acute coronary events (n=6,822). Presence of additional comorbidities vs. Fewer comorbidities was evaluated on High level of hs-cTnT (≥32 ng/L) (OR 1.311, 95% CI 1.272-1.352, p=<0.001). Each additional comorbidity significantly increased the odds of having high hs-cTnT levels (AOR 1.311), demonstrating a greater impact than each year of advancing age (AOR 1.073) in elderly patients without acute coronary syndrome.
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