Key result
Peak hs-TnI independently predicts in-hospital mortality in acute myocardial infarction with modest discrimination.
Why the study?
While the diagnostic role of high-sensitivity cardiac troponin in acute myocardial infarction is well established, the prognostic value of peak hs-TnI on in-hospital mortality and length of stay in STEMI and NSTEMI remains variable.
Does peak hs-TnI level from early serial measurements predict in-hospital mortality and length of stay in adult patients with STEMI and NSTEMI?
Cohort (n=335)
No
Does peak hs-TnI level from early serial measurements predict in-hospital mortality and length of stay in adult patients with STEMI and NSTEMI?
Peak high-sensitivity troponin I from early serial measurements independently predicts in-hospital mortality with modest discrimination (AUC 0.63) in STEMI and NSTEMI patients, though it does not correlate with hospital length of stay.
hs-TnI may aid in-hospital mortality risk stratification in MI; extends observational data but leaves open prospective validation.
Background: High-sensitivity cardiac troponin (hs‑Tn) is a cornerstone biomarker in acute myocardial infarction. While its diagnostic role is well established, the prognostic value of peak hs‑Troponin I (hs‑TnI) on in-hospital outcomes remains variable. Objective: To investigate the effect of peak hs-TnI levels on in-hospital mortality and length of stay among patients with STEMI (ST-segment elevation myocardial infarction) and NSTEMI (non ST-segment elevation myocardial infarction). Methods: This retrospective cohort study used data from the Acute Coronary Syndrome Registry of Dr. Saiful Anwar General Hospital, East Java, Indonesia, collected between July 2023 and December 2024. Adult patients with STEMI or NSTEMI who underwent at least two hs-TnI measurements during early hospitalization were included. Peak hs-TnI was defined as the highest value recorded from early serial measurements without a predefined sampling interval. Multivariable logistic regression analysis was performed to identify independent predictors of in-hospital mortality, and the association with length of hospital stay was evaluated using non-parametric correlation analysis. Result: Among 335 included patients, those who died during hospitalization had significantly higher peak hs-TnI levels than survivors (p < 0.001). After adjustment for age, Killip class, and CRUSADE score, peak hs-TnI remained independently associated with in-hospital mortality. Discriminative performance was modest (AUC 0.63). No significant association was found between peak hs-TnI levels and length of hospital stay. Conclusion: Peak hs-TnI from early serial measurements is an independent predictor of in-hospital mortality in STEMI and NSTEMI but is not associated with length of hospital stay.
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Utomo et al. (2026) conducted a cohort in STEMI and NSTEMI (n=335). Peak high-sensitivity troponin I (hs-TnI) vs. Lower peak hs-TnI levels / survivors was evaluated on In-hospital mortality and length of hospital stay (AUC 0.63, p=<0.001). Peak hs-TnI was significantly higher in non-survivors (p<0.001) and independently predicted in-hospital mortality in STEMI/NSTEMI (AUC 0.63), with no association with length of stay.
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