Troponin in non-cardiac department—finding a stray piece of puzzle?

The results of the Oh et al. analysis (1) "Association between cardiac troponin testing at scheduled admission and mortality in patients with comorbidities" presents the utility of troponin I screening test basing on the analysis performed on 289,764 consecutive asymptomatic patients who were admitted from the outpatient clinic to non-cardiological/non-cardiac surgery departments.Although the elevation of myocardial marker was found in only 8% of screened patients, the superior clinical course within 1 year was achieved by cardiologists' consultation and additional examinations, followed by further management and therapy changes.Two important findings of the study are related to increased clinical vigilance with troponin use.First, the survival rate was higher in the subgroup who underwent more meticulous diagnostics followed by implementation of targeted therapy.Troponin measurement is currently routinely used in acute coronary syndromes diagnostics.However, its significance is still high in the management of patients in whom myocardial infarction was ruled out.The most important value is further introduction or intensification of pharmacological or interventional therapy.Second, the mortality was higher in patients with troponin I elevation despite more accurate management.This observation is reasonable and results from well-known worse prognosis in patients burdened with cardiovascular morbidity characterized with troponin rise.