Raised level of heart attack protein linked to heightened risk of death, study shows

A high level of troponin-a protein normally used to exclude the possibility of a heart attack in patients with chest pain-may signal a heightened risk of death from any cause within the next couple of years, even in the absence of known or suspected cardiovascular disease, suggests research published online in the journal Heart. High cardiac troponin levels are often seen in hospital patients who don’t have specific signs of a heart attack, but the clinical significance of this has never been clear, say the researchers.

To explore this further, they tracked the survival of 20,000 hospital patients who had had a troponin blood test for any reason between June and August 2017 at a large teaching hospital, regardless of the original clinical indication.

Cardiac troponin was high in 1085 (just under 5.5%) patients. Some 1782 (9%) patients died after a year, and a total of 2825 (14%) had died just over 2 years (809 days) later. Patients were nearly 4 times as likely to die if their cardiac troponin test result was high (45%) as those whose test results fell within the normal range (12%).

Further analysis accounting for age, sex, hospital location, and kidney function revealed that an abnormally high cardiac troponin level was independently associated with a 76% heightened risk of death, not only from both cardiovascular disease, but also other causes.

Reference: Association between troponin level and medium-term mortality in 20 000 hospital patients, Heart, DOI 10.1136/heartjnl-2023-322463