Short- and Mid-Term Outcomes in Emergency Department Patients Discharged with Elevated High-Sensitivity Troponin I: A Retrospective Cohort Study

Q: What are the key findings of this study?

Elevated high-sensitivity cardiac troponin I levels in patients discharged from the emergency department were associated with a significantly higher 90-day mortality rate compared to normal levels (7.0% vs 2.1%; OR 3.56).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Elevated high-sensitivity cardiac troponin I without acute coronary syndrome (n=1144). Intervention: Elevated high-sensitivity cardiac troponin I (>15 ng/L) vs. Normal high-sensitivity cardiac troponin I (≤15 ng/L). Primary outcome: 90-day all-cause mortality (OR 3.56, 95% CI 1.85-6.85, p=<0.001).

Q: What does this research mean for the field?

Patients discharged from the emergency department with elevated high-sensitivity cardiac troponin I levels have a significantly higher risk of 90-day all-cause mortality compared to patients with normal levels. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the short- and mid-term outcomes of patients discharged from the emergency department with elevated high-sensitivity cardiac troponin I levels in the absence of standardized management protocols.

Kürşat Kaan Kerimoğlu

doi:10.69601/meandrosmdj.1859647

September 23, 2026Meandros Medical And Dental JournalOpen Access

Short- and Mid-Term Outcomes in Emergency Department Patients Discharged with Elevated High-Sensitivity Troponin I: A Retrospective Cohort Study

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Key result

Elevated hs-cTnI at ED discharge is linked to ~256% higher 90-day mortality.

OR 3.56
95% CI 1.85-6.85
P<0.001
n=1,144

Why the study?

Does elevated hs-cTnI at ED discharge predict increased mortality and healthcare revisits in adult patients without acute coronary syndrome?

Key Points

To evaluate the short- and mid-term outcomes of patients discharged from the emergency department with elevated high-sensitivity cardiac troponin I levels in the absence of standardized management protocols.
Conducted a retrospective case-control study of adult patients discharged from an emergency department between January 2023 and December 2024, comparing patients with elevated hs-cTnI levels (>15 ng/L) to matched controls with normal levels (≤15 ng/L).
Excluded patients diagnosed with acute coronary syndrome, those admitted after the initial visit, and those lacking complete 30-day and 90-day follow-up data, leaving 568 cases and 576 controls matched on age (within ±2 years) and presentation date (within ±7 days).
Tracked primary outcomes of 30-day and 90-day all-cause mortality and healthcare revisits via institutional records, the national electronic health registry, and telephone interviews.
The 90-day mortality rate was significantly higher in the elevated hs-cTnI group than in the control group (7.0% vs 2.1%; OR = 3.56).
Presenting complaints in the elevated hs-cTnI group versus controls included chest pain in 40.3% (n = 229) versus 47.7% (n = 275), dyspnea in 14.4% (n = 82) versus 8.5% (n = 49), and palpitations in 12.1% (n = 69) versus 12.3% (n = 71).

Study Design

Type

Cohort (n=1,144)

Multicenter

No

Structured PICO

Does elevated hs-cTnI at ED discharge predict increased mortality and healthcare revisits in adult patients without acute coronary syndrome?

P

Population

1,144 adult patients discharged from the emergency department without acute coronary syndrome, followed for 90 days to assess the prognostic impact of elevated versus normal high-sensitivity cardiac troponin I levels.

E

Exposure

Elevated high-sensitivity cardiac troponin I (hs-cTnI) levels (>15 ng/L) at discharge

C

Comparator

Normal hs-cTnI levels (≤15 ng/L) at discharge, matched for age (±2 years) and date of presentation (±7 days)

O

Outcome

30-day and 90-day all-cause mortality and subsequent healthcare revisitshard clinical

Main Result

Odds Ratio: 3.56 (95% CI 1.85–6.85)

Absolute Event Rate: 7% vs 2.1%

p-value: p=<0.001

Patients discharged from the ED with elevated hs-cTnI levels, even without confirmed ACS, have a significantly higher risk of 90-day mortality and healthcare revisits, highlighting the need for structured follow-up.

Limitations

Retrospective design limits causal inference
Dependence on symptom-based ICD-10 discharge codes may have reduced diagnostic accuracy
Timing and number of hs-cTnI measurements were based on physician-directed real-world ED practice rather than a standardized study protocol
Consistent follow-up with serial ECGs could not be confirmed for all patients
Retrospective design
Lack of a standardized serial troponin algorithm for the entire cohort

Implication

Should not yet change ED discharge practices; hypothesis-generating for prospective studies on troponin-guided follow-up.

Abstract

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Discussion

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Cite This Study

Kürşat Kaan Kerimoğlu (2026) conducted a cohort in Elevated high-sensitivity cardiac troponin I without acute coronary syndrome (n=1,144). Elevated high-sensitivity cardiac troponin I (>15 ng/L) vs. Normal high-sensitivity cardiac troponin I (≤15 ng/L) was evaluated on 90-day all-cause mortality (OR 3.56, 95% CI 1.85-6.85, p=<0.001). Elevated high-sensitivity cardiac troponin I levels in patients discharged from the emergency department were associated with a significantly higher 90-day mortality rate compared to normal levels (7.0% vs 2.1%; OR 3.56).

synapsesocial.com/papers/6ab6102e406bf401c14696fc https://doi.org/10.69601/meandrosmdj.1859647

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Short- and Mid-Term Outcomes in Emergency Department Patients Discharged with Elevated High-Sensitivity Troponin I: A Retrospective Cohort Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Short- and Mid-Term Outcomes in Emergency Department Patients Discharged with Elevated High-Sensitivity Troponin I: A Retrospective Cohort Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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