Citation

Maréchaux S, Lubret R, Delsart P, Hattabi M, Six-Carpentier MM, Carpentier E, Coutant V, Pinçon C, Le Tourneau T, Puisieux F, Goldstein P, Asseman P, Ennezat PV. Emerg. Med. J. 2010; 27(6): 446-450.

Affiliation

Department of Cardiology and Intensive Care Unit, CHRU de Lille, Lille cedex, France.

Copyright

(Copyright © 2010, BMJ Publishing Group)

DOI

10.1136/emj.2009.076406

PMID

20562140

Abstract

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 > or =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 > or =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 > or =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.

Language: en