Prognostic value of cardiac troponin in elderly patients with paroxysmal supraventricular tachycardia: A multicenter study

Background: An elevated level of cardiac troponin I (cTnI) frequently accompanies an episode of supraventricular tachycardia (SVT). However, the predictive value of cTnI in elderly SVT patients has not been examined.Methods: We collected the electronic medical records of elderly SVT patients (over 65 years old) who visited four Taiwanese emergency departments over a 2-year period. The patients who underwent cTnI testing were in-cluded in the cohort and further categorized based on their cTnI results (positive or negative). The study's pri-mary outcomes were the 5-year risks of major adverse cardiovascular events (MACE) and SVT recurrence.Results: One hundred and twenty-four patients met the inclusion criteria. Of these patients, 39 (31.5%) had a pos-itive cTnI result, and 85 (68.5%) had a negative cTnI result. Patients with a positive cTnI result were older (p = 0.029) and had a longer hospital stay (p = 0.023) than those with a negative cTnI result. Multivariate analysis showed that age > 75 years (OR = 2.41; 95% CI 1.07-5.45; p = 0.034) was an independent predictor for cTnI el-evation. In the survival analysis, no difference in the incidence of five-year MACE (p = 0.656) was observed be-tween the cTnI-positive and cTnI-negative groups. Multivariate analysis revealed that a history of coronary artery disease was the only significant independent risk factor for MACE (HR = 4.30; 95% 95% CI 1.41-13.05; p = 0.010). For SVT recurrence, the multivariate analysis revealed that previous SVT (HR = 3.37; 95% CI 1.53-7.39; = 0.002), smoking history (HR = 2.32; 95% CI 1.03-5.24; p = 0.043), and RFA treatment (HR = 0.20; 95% CI 0.06-0.65; p = 0.008) were significant independent predictors.Conclusions: An increased cardiac troponin level may not effectively indicate the risk of MACE in elderly SVT pa-tients. Physicians might want to be cautious when interpreting troponin test results for this specific patient group.(c) 2023 Elsevier Inc. All rights reserved.