Our data highlights the importance of interpreting hs-cTNT as an important risk predictor in patients presenting with acute dyspnea at the ED and without primary cardiac disease. Importantly, this seems to address patients with specific comorbidities such as renal impairment as well as heart failure and atrial flutter.
We also had no data on whether the patients had undergone testing for cardiac diseases before and after inclusion of the study or if there was any previous contact with an cardiologist. Neither do we have data whether the patients were prescribed any preventive medicine, for example aspirin. The strength of the study is the very carefully characterized cohort of patients admitted to ED due to acute dyspnea used in this study. All patients entered normal triage in the emergency department, with thorough clinical assessment, blood testing, clinical examination and if given, further clinical care. Data have afterwards been linked to national registries for additional information.
In conclusion, we show that hs-cTnT levels predicted risk of 3-months mortality among patients with dyspnea at the ED without an acute coronary syndrome. Hs-cTnT seems to be an important biomarker within this patient group and elevated levels indicate a need for thorough investigation and to be tested prospectively for possible implementation in clinical guidelines.
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