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Research Article

Elevated troponin in patients with acute gastrointestinal bleeding: prevalence, predictors and outcomes

    Omar Kousa

    Department of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    ,
    Yazan Addasi

    Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    ,
    Akshay Machanahalli Balakrishna

    *Author for correspondence: Tel.: +1 531 777 4003;

    E-mail Address: dr.akshaymb@gmail.com

    Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    ,
    Venkata Siva Kumar Pajjuru

    Department of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    ,
    Josiah K Bardwell

    Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    ,
    Ryan W Walters

    Department of Clinical Research, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    ,
    Shiva Ponamgi

    Department of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    &
    Venkata Mahesh Alla

    Department of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, NE 68124, USA

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    Published Online:30 Jun 2022https://doi.org/10.2217/fca-2021-0143

    Abstract

    Background: Cardiac troponin (cTn) can also be elevated in patients with non-cardiac illnesses. The utility of elevated cTn in patients with acute gastrointestinal bleeding (AGIB) is unclear. Methods: We retrospectively identified all patients admitted with AGIB who had cTn ordered. We assessed the prevalence, predictors and mortality. Results: A total of 172 patients with AGIB were included in the study, of whom 17% had abnormal cTn. Predictors of elevated cTn were advanced age, lower BMI, coronary artery disease and chronic kidney disease. The abnormal cTn group had more cardiac consultation and procedures and longer length of stay. However, there was no difference in mortality between the two groups. Conclusion: Elevated cTn in patients with AGIB was associated with more cardiology consultation and downstream cardiac testing, greater delay to endoscopic evaluation and longer length of stay, without significantly affecting the mortality.

    Plain language summary

    Cardiac troponin (cTn) is a type of protein found in the heart muscles. It is released into the bloodstream when heart muscles become damaged. However, cTn can also be elevated in patients with non-cardiac illnesses, such as critically ill patients and patients with acute gastrointestinal bleeding (AGIB). This study analyzed the relationship between elevated cTn and the outcomes (including prevalence, predictors and mortality) in patients with AGIB. A total of 172 patients with AGIB were evaluated. They were divided into groups based on the presence of elevated cTn. The prevalence of elevated cTn in AGIB patients was 17%. Older age, lower BMI, coronary artery disease and chronic kidney disease were found to be some of the factors that can predict cTn elevation in AGIB patients. AGIB patients with elevated cTn had more cardiology service consultations and procedures and longer lengths of hospital stay. However, there was no effect of elevated cTn on the death rate of AGIB patients.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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