University of Oulu

Jaakkola, S.; Paana, T.; Nuotio, I.; Kiviniemi, T.O.; Pouru, J.-P.; Porela, P.; Biancari, F.; Airaksinen, K.E.J. Etiology of Minor Troponin Elevations in Patients with Atrial Fibrillation at Emergency Department–Tropo-AF Study. J. Clin. Med. 2019, 8, 1963.

Etiology of minor troponin elevations in patients with atrial fibrillation at emergency department-tropo-AF study

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Author: Jaakkola, Samuli1; Paana, Tuomas1; Nuotio, Ilpo1,2;
Organizations: 1Heart Center, Turku University Hospital and University of Turku, 20521 Turku, Finland
2Department of Acute Internal Medicine, Turku University Hospital and University of Turku, 20521 Turku, Finland
3Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
4Research Unit of Surgery, Anesthesiology and Critical Care, University of Oulu, 90014 Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link:
Language: English
Published: Multidisciplinary Digital Publishing Institute, 2019
Publish Date: 2020-03-27


Patients with atrial fibrillation (AF) presenting to the emergency department (ED) often have elevated cardiac troponin T (TnT) levels without evidence of type 1 myocardial infarction. We sought to explore the causes and significance of minor TnT elevations in patients with AF at the ED. All patients with AF admitted to the ED of Turku University Hospital between 1 March, 2013 and 11 April, 2016, and at least two TnT measurements, were screened. Overall, 2911 patients with a maximum TnT of 100 ng/L during hospitalization were analyzed. TnT was between 15 and 100 ng/L in 2116 patients. The most common primary discharge diagnoses in this group were AF (18.1%), infection (18.3%), ischemic stroke/transient ischemic attack (10.7%), and heart failure (5.0%). Acute coronary syndrome (ACS) was equally uncommon both in patients with normal TnT and elevated TnT (4.4% vs. 4.5%). Age ≥75 years, low estimated glomerular filtration rate (eGFR), high C-reactive protein (CRP), and hemoglobin <10.0 g/dL, were the most important predictors of elevated TnT. Importantly, TnT elevation was a very frequent (>93%) finding in elderly (≥75 years) AF patients with either low eGFR or high CRP. In conclusion, minor TnT elevations carry limited diagnostic value in elderly AF patients with comorbidities.

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Series: Journal of clinical medicine
ISSN: 2077-0383
ISSN-E: 2077-0383
ISSN-L: 2077-0383
Volume: 8
Issue: 11
Article number: 1963
DOI: 10.3390/jcm8111963
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was funded by The Finnish Foundation for Cardiovascular Research, Helsinki, Finland, and State Clinical Research Fund (EVO) of Turku University Hospital, Turku, Finland.
Copyright information: © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (