Prognostic significance of troponin in patients with malignancy (NIHR Health Informatics Collaborative TROP-MALIGNANCY study).

Autor:	Samuel NA; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.; NIHR Oxford Biomedical Research Centre, University of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, U.K., Roddick A; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.; NIHR Oxford Biomedical Research Centre, University of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, U.K., Glampson B; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K., Mulla A; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K., Davies J; NIHR Oxford Biomedical Research Centre, University of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, U.K., Papadimitriou D; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K., Panoulas V; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.; National Heart and Lung Institute, Imperial College London, London, U.K., Mayer E; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.; Department of Surgery & Cancer, Imperial College London, London, UK., Woods K; NIHR Oxford Biomedical Research Centre, University of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, U.K., Shah AD; Hospitals Biomedical Research Centre, NIHR University College London, University College London and University College London Hospitals NHS Foundation Trust, London, U.K., Gautama S; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K., Elliott P; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.; Health Data Research UK, London Substantive Site, London, U.K., Hemmingway H; Hospitals Biomedical Research Centre, NIHR University College London, University College London and University College London Hospitals NHS Foundation Trust, London, U.K.; Health Data Research UK, London Substantive Site, London, U.K., Williams B; Hospitals Biomedical Research Centre, NIHR University College London, University College London and University College London Hospitals NHS Foundation Trust, London, U.K., Asselbergs FW; Hospitals Biomedical Research Centre, NIHR University College London, University College London and University College London Hospitals NHS Foundation Trust, London, U.K., Melikian N; NIHR King's Biomedical Research Centre, King's College London and King's College Hospital NHS Foundation Trust, London, U.K., Kharbanda R; NIHR Oxford Biomedical Research Centre, University of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, U.K., Shah AM; NIHR King's Biomedical Research Centre, King's College London and King's College Hospital NHS Foundation Trust, London, U.K., Perera D; NIHR King's Biomedical Research Centre, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, U.K., Patel RS; Hospitals Biomedical Research Centre, NIHR University College London, University College London and University College London Hospitals NHS Foundation Trust, London, U.K., Channon KM; NIHR Oxford Biomedical Research Centre, University of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, U.K., Mayet J; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.. j.mayet@imperial.ac.uk.; National Heart and Lung Institute, Imperial College London, London, U.K.. j.mayet@imperial.ac.uk.; Imperial College Healthcare NHS Trust, Hammersmith Hospital, NHLI offices, B Block 2nd Floor, Du Cane Road, W12 0HS, London, U.K.. j.mayet@imperial.ac.uk., Shah ASV; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.; National Heart and Lung Institute, Imperial College London, London, U.K.; London School of Hygiene Tropical Medicine, London, U.K., Kaura A; NIHR Imperial Biomedical Research Centre, Imperial College London and Imperial College Healthcare NHS Trust, London, U.K.; National Heart and Lung Institute, Imperial College London, London, U.K.
Jazyk:	angličtina
Zdroj:	Cardio-oncology (London, England) [Cardiooncology] 2024 Jul 05; Vol. 10 (1), pp. 41. Date of Electronic Publication: 2024 Jul 05.
DOI:	10.1186/s40959-024-00238-w
Abstrakt:	Background: Cardiac troponin is commonly raised in patients presenting with malignancy. The prognostic significance of raised troponin in these patients is unclear. Objectives: We sought to investigate the relation between troponin and mortality in a large, well characterised cohort of patients with a routinely measured troponin and a primary diagnosis of malignancy. Methods: We used the National Institute for Health Research (NIHR) Health Informatics Collaborative data of 5571 patients, who had troponin levels measured at 5 UK cardiac centres between 2010 and 2017 and had a primary diagnosis of malignancy. Patients were classified into solid tumour or haematological malignancy subgroups. Peak troponin levels were standardised as a multiple of each laboratory's 99th -percentile upper limit of normal (xULN). Results: 4649 patients were diagnosed with solid tumours and 922 patients with haematological malignancies. Raised troponin was an independent predictor of mortality in all patients (Troponin > 10 vs. <1 adjusted HR 2.01, 95% CI 1.73 to 2.34), in solid tumours (HR 1.84, 95% CI 1.55 to 2.19), and in haematological malignancy (HR 2.72, 95% CI 1.99 to 3.72). There was a significant trend in increasing mortality risk across troponin categories in all three subgroups (p < 0.001). Conclusion: Raised troponin level is associated with increased mortality in patients with a primary diagnosis of malignancy regardless of cancer subtype. Mortality risk is stable for patients with a troponin level below the ULN but increases as troponin level increases above the ULN in the absence of acute coronary syndrome. (© 2024. The Author(s).)
Databáze:	MEDLINE
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