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Small rise in heart attack protein linked to increased risk of early death

 

An analysis of patients’ heart data has shown that even a small increase in a protein linked to heart attacks is linked to an increased risk of death.

Clinicians use blood levels of a protein called troponin, alongside other investigations, to determine whether a patient is having a heart attack and to inform treatment choices. It has been assumed that the higher the amount of troponin in the blood, the higher the risk of death in all age groups.

In a large new study, published in the British Medical Journal, researchers from the NIHR Health Informatics Collaborative confirmed that a raised troponin level is associated with an increase in risk of death in all age groups. This was seen even if the troponin result was only slightly raised, with the increased risk of death occurring very early.

The study also showed that the higher the amount of troponin in the blood, the higher the risk of death in patients with a heart attack, that regardless of age. The results suggest that even a small rise in troponin is clinically significant in all age groups and can indicate underlying health problems.

However, the team also found that, contrary to what they expected, very high levels of troponin in the blood in patients with a heart attack was associated with a lower risk of dying. A possible reason is that patients with very high troponin levels are more likely to have a type of heart attack that can be treated effectively with an operation to improve blood flow to the heart, therefore reducing their risk of dying.

Amit Kaura, lead author of the research and NIHR Clinical Research Fellow at Imperial College London, said: “This is the first study to address the implications of raised troponin in a real world large sample of patients across a wide range of ages.

“Doctors will be able to use this information to help identify the risk of early death in patients who have a troponin level measured. This could lead to interventions at a much earlier stage in a wider group of patients than are currently treated.”

The NIHR Health Informatics Collaborative improves the quality and availability of routinely collected NHS clinical data for use in translational research. The collaborative brings together comparable, comprehensive patient data at all NHS trusts with NIHR Biomedical Research Centres and enables data sharing and re-use across the trusts and partner organisations.

For this study, funded by NIHR Imperial Biomedical Centre, the researchers used anonymised cardiovascular data from more than 250,000 patients who had undergone troponin tests at five hospital trusts in the NIHR Health Informatics Collaborative.

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