Advertisement
Editorial| Volume 361, ISSUE 3, P285-286, March 2021

Repercussions from Indiscriminate Use of Cardiac Troponin for Intensive Care Patients

Published:December 25, 2020DOI:https://doi.org/10.1016/j.amjms.2020.12.017
Repercussions from Indiscriminate Use of Cardiac Troponin for Intensive Care Patients
Next ArticleRelationship Between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Etiology of Acute Kidney Injury (AKI)
      For a multitude of reasons, including concern for patient outcomes, limited self-efficacy, and distress about professional liability, many clinicians are apprehensive about diagnosing and managing cardiovascular disease. This apprehension drives substantial demand for consultation with teams of cardiovascular professionals in the inpatient and outpatient setting. In this issue of the Journal, Kousa et al report on a cohort of patients receiving intensive care with elevated cardiac troponin (Tn) and without evidence of acute coronary syndrome.

      Kousa O, Essa A, Saleh M, et al. The impact of cardiology consultation on medical intensive care unit patients with elevated troponin levels [In press]. 2020. Published online September 7, 2020.

      They found that most patients received a cardiology consultation that was associated with more testing and no difference in short-term or long-term mortality. Their findings suggest that routine cardiology consultation for such patients may not be a high value exercise.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of the Medical Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

      1. Kousa O, Essa A, Saleh M, et al. The impact of cardiology consultation on medical intensive care unit patients with elevated troponin levels [In press]. 2020. Published online September 7, 2020.

        View in Article
        • Ganguli I
        • Simpkin AL
        • Lupo C
        • et al.
        Cascades of care after incidental findings in a US National Survey of Physicians.
        JAMA Netw Open. 2019; 2e1913325
        View in Article

      3. Januzzi JL. Troponin and BNP Use in COVID-19.https://www.acc.org/latest-in-cardiology/articles/2020/03/18/15/25/troponin-and-bnp-use-in-covid19. Accessed September 14, 2020.

        View in Article

      4. Sandoval Y, Jaffe AS. Key Points About Myocardial Injury and Cardiac Troponin in COVID-19.https://www.acc.org/latest-in-cardiology/articles/2020/07/17/08/00/key-points-about-myocardial-injury-and-cardiac-troponin-in-covid-19. Accessed September 14, 2020.

        View in Article
        • Hinton J
        • Mariathas M
        • Grocott MP
        • Curzen N
        High sensitivity troponin measurement in critical care: Flattering to deceive or ‘never means nothing’?.
        J Intensiv Care Soc. 2020; 21: 232-240
        View in Article
        • Lim W
        • Qushmaq I
        • Devereaux PJ
        • et al.
        Elevated cardiac troponin measurements in critically ill patients.
        Arch Intern Med. 2006; 166: 2446-2454
        View in Article
        • Wang G
        • Wang J
        • Wu S
        • et al.
        Clinical impact of using a more sensitive troponin assay in patients with acute chest pain.
        Clin Cardiol. 2019; 42: 561-567
        View in Article
        • Zachoval CF
        • Dolscheid-Pommerich R
        • Graeff I
        • et al.
        High-sensitivity troponin T testing: consequences on daily clinical practice and effects on diagnosis of myocardial infarction.
        J Clin Med. 2020; 9: 775
        View in Article
        • DeFilippis AP
        • Chapman AR
        • Mills NL
        • et al.
        Assessment and Treatment of Patients With Type 2 myocardial infarction and acute nonischemic myocardial injury.
        Circulation. 2019; 140: 1661-1678
        View in Article

      10. Critical Care Societies Collaborative. Choosing Wisely. https://www.choosingwisely.org/clinician-lists/#parentSociety=Critical_Care_Societies_Collaborative. Accessed September 17, 2020.

        View in Article

      Article info

      Publication history

      Published online: December 25, 2020
      Accepted: December 21, 2020
      Received: September 21, 2020

      Footnotes

      Funding: This work is supported with resources and the use of facilities at the Malcom Randall VAMC. Dr. Winchester is supported by Career Development Award #13-023 from the United States Department of Veterans Affairs Health Services Research and Development (HSR&D) Program.

      Disclosures: Contents do not represent the views of the Department of Veterans Affairs or the U.S. Government. The author reports no relationships that could be construed as a conflict of interest.

      Identification

      DOI: https://doi.org/10.1016/j.amjms.2020.12.017

      Copyright

      Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX