High-sensitivity cardiac troponin T: A biomarker for the early risk stratification of type-A acute aortic dissection?

Summary Background High-sensitivity cardiac troponin is the most specific and sensitive biomarker of myocardial injury. However, no study has investigated whether the early concentration of high-sensitivity cardiac troponin is increased or is of value in predicting short-term prognosis in patients with type-A acute aortic dissection (AAD) in the emergency department. Aims To measure the high-sensitivity cardiac troponin T (hs-TnT) concentration in patients with type-A AAD upon hospital admission, and to assess its value in predicting short-term prognosis. Methods We enrolled consecutive patients with type-A AAD. Blood samples were collected on admission; hs-TnT concentrations were measured on the Elecsys 2010 system. High-sensitivity C-reactive protein (hs-CRP), D-dimer and other biochemical indicators were measured. Patients were divided into two groups according to hs-TnT concentration on admission ( Results More than half (61.2%) of the 103 included patients had an hs-TnT concentration ≥ 0.014 ng/mL. hs-TnT concentrations were significantly higher in those who died compared with survivors (0.292 ± 0.516 vs. 0.069 ± 0.154 ng/mL; P  = 0.003). Multivariable Cox regression analysis suggested that hs-TnT is an independent factor for predicting in-hospital mortality risk (odds ratio: 2.202, 95% confidence interval: 1.111–4.367; P  = 0.024). Kaplan–Meier curves revealed a significant increase in hospital mortality in the hs-TnT(+) group compared with the hs-TnT(–) group ( P  = 0.021). When hs-TnT was ≥ 0.042 ng/mL, the sensitivity and specificity in predicting hospital short-term mortality were 70.8% and 76.4%, respectively. Conclusions Our study suggests that hs-TnT concentration could be used as an early biomarker for the risk stratification of patients with type-A AAD in the emergency department; the relationship between hs-TnT concentration and long-term prognosis needs further investigation.