Objectives To assess the clinical significance of unsuspected rise in cardiac troponin I (cTnI) levels in elderly patients who have fallen.
Design Monocentre prospective observational pilot study
Participants Consecutive elderly patients (age >65 years) referred to the emergency department after being immobilised on the ground after a fall.
Measurements Clinical, laboratory and Doppler echocardiography data were collected on admission to assess the cardiac correlates of increased cTnI. The survival endpoint was a composite of death or cardiovascular event.
Results 60 patients were included in this study. Mean age was 81±8 years. Cardiac TnI was ≥0.05 ng/ml in at least one blood sample in 40 patients (67%). New diagnosis of cardiac disease was performed in 14 patients, 13 of them had cTnI ≥0.05 ng/ml. Transient apical ballooning was diagnosed in six patients. During a median follow-up of 92 (49–131) days death occurred in six patients, myocardial infarction in three, stroke in one and acute heart failure in five. Cardiac TnI ≥0.05 ng/ml was a predictor of these events (p=0.034).
Conclusion An unsuspected rise in cTnI correlates with new diagnosis of cardiac disease and is a potential marker of stress induced cardiomyopathy in elderly patients who fall. Cardiac TnI might be a strong predictor of outcome in these patients.
- elderly people
- cardiac troponin
- neurology, other
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Sponsor's role: the study was not supported by any sponsor.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; not externally peer reviewed.