Objective To investigate the value of hs-cTnT in predicting all-cause death in the elderly with SCAD.Methods A prospective cohort observation study was conducted on 274 old adults with SCAD hospitalized in our department from January 2016 to January 2019.Their hs-cTnT level was measured,and according to the results,they were divided into lower(≤13.0 ng/L,94 cases),middle(14.0-22.0 ng/L,94 cases)and upper(≥23.0 ng/L,86 cases)tertile groups.The general clinical data were compared among the three groups.Kaplan-Meier survival curve was drawn to analyze the survival differences among groups.Cox proportional hazards regression analysis was applied to identify risk factors for mortality.ROC curve analysis was applied to evaluate the predictive value of hs-cTnT for all-cause mortality.Results During a me-dian follow-up period of 32 months,62(22.63％)patients died among the 274 patients,account-ing for 75.8％dying of non-cardiovascular diseases.There were statistically differences in the three tertile groups in terms of age,male ratio,proportions of hypertension,chronic obstructive pulmonary disease and chronic kidney disease,number of comorbidities,estimated glomerular fil-tration rate,albumin and hemoglobin levels,left ventricular ejection fraction,left ventricular mass index,and mortality rate(P＜0.05,P＜0.01).COX proportional hazards regression model showed the upper tertile group had significantly lower cumulative survival rate than the middle and lower tertile groups(Plog rank＜0.01).Multivariate Cox proportional hazards regression analysis indicated that hs-cTnT≥23.0 ng/L level was still a risk factor for death in both model 2(HR=3.749,95％CI:1.703-8.256,P=0.001)and model 3(HR=2.990,95％CI:1.358-6.581,P=0.007).ROC curve analysis revealed that the AUC value of hs-cTnT level in predicting death was 0.736,with a cut-off value of 25 ng/L.Conclusion For elderly SCAD patients,despite the existence of multiple comorbidities and the priority of non-cardiovascular death,hs-cTnT,a marker reflecting myocar-dial injury,is still a predictor for risk of death in the population.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.

Objective To investigate the value of hs-cTnT in predicting all-cause death in the elderly with SCAD.Methods A prospective cohort observation study was conducted on 274 old adults with SCAD hospitalized in our department from January 2016 to January 2019.Their hs-cTnT level was measured,and according to the results,they were divided into lower(≤13.0 ng/L,94 cases),middle(14.0-22.0 ng/L,94 cases)and upper(≥23.0 ng/L,86 cases)tertile groups.The general clinical data were compared among the three groups.Kaplan-Meier survival curve was drawn to analyze the survival differences among groups.Cox proportional hazards regression analysis was applied to identify risk factors for mortality.ROC curve analysis was applied to evaluate the predictive value of hs-cTnT for all-cause mortality.Results During a me-dian follow-up period of 32 months,62(22.63％)patients died among the 274 patients,account-ing for 75.8％dying of non-cardiovascular diseases.There were statistically differences in the three tertile groups in terms of age,male ratio,proportions of hypertension,chronic obstructive pulmonary disease and chronic kidney disease,number of comorbidities,estimated glomerular fil-tration rate,albumin and hemoglobin levels,left ventricular ejection fraction,left ventricular mass index,and mortality rate(P＜0.05,P＜0.01).COX proportional hazards regression model showed the upper tertile group had significantly lower cumulative survival rate than the middle and lower tertile groups(Plog rank＜0.01).Multivariate Cox proportional hazards regression analysis indicated that hs-cTnT≥23.0 ng/L level was still a risk factor for death in both model 2(HR=3.749,95％CI:1.703-8.256,P=0.001)and model 3(HR=2.990,95％CI:1.358-6.581,P=0.007).ROC curve analysis revealed that the AUC value of hs-cTnT level in predicting death was 0.736,with a cut-off value of 25 ng/L.Conclusion For elderly SCAD patients,despite the existence of multiple comorbidities and the priority of non-cardiovascular death,hs-cTnT,a marker reflecting myocar-dial injury,is still a predictor for risk of death in the population.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.