TY - JOUR T1 - How do comorbidities influence troponin concentrations? JF - Heart JO - Heart SP - 634 LP - 635 DO - 10.1136/heartjnl-2019-316283 VL - 106 IS - 9 AU - Johannes Tobias Neumann AU - Raphael Twerenbold Y1 - 2020/05/01 UR - http://heart.bmj.com/content/106/9/634.abstract N2 - Cardiac troponin is the most established biomarker for acute cardiac care and recommended for the diagnosis of acute myocardial infarction (MI).1 2 Cardiac troponin concentrations above the 99th percentile are defined as pathological and indicate myocardial injury, not necessarily caused by underlying acute or chronic ischaemia.3 The 99th percentile itself is determined in a healthy population, whereas elevated troponin concentrations above this cut-off are regarded as abnormal. A multitude of comorbidities and conditions other than myocardial ischaemia can influence troponin concentrations in the acute or chronic setting. This includes, among many others, age, sex, renal dysfunction and prevalent cardiovascular diseases.1 4 Such confounders are frequent bystanders in the setting of an acute MI and can complicate the diagnostic evaluation. Peak cardiac troponin concentrations correlate with infarct size in imaging modalities and thereby contain strong prognostic information. How peak cardiac troponin concentrations in patients with MI are influenced by comorbidities has been poorly explored. In their present Heart manuscript, Sundaram and colleagues5 investigated the association of peak cardiac troponin concentrations with various comorbidities in a very large registry data set. Between 2003 and 2013, data from more than 330 000 patients with MI were collected within the UK-wide Myocardial Ischemia National … ER -