4. It Is Prognostic
Even when hsTn elevation is not caused by MI, it still provides important information. In every condition in which it has been assessed, elevated troponin levels correlate with an adverse prognosis (figure 2). Examples would include heart failure, atrial fibrillation, renal failure, pulmonary embolism, sepsis and surgery. These findings are not confined to acute illness but also apply to chronic stable disease. For example, in stable outpatients with risk factors for coronary disease, the level of hsTnT detected in stored blood samples correlated closely with prognosis, with the highest risk group, who had hsTnT of over 14 ng/L, having a four-times higher risk of death over a mean follow-up period of 9.4 years.
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Figure 2.
Risk and likelihood of MI depends on the level of troponin, but the relationship is not straightforward
Key: MI = myocardial infarction