Elevated Troponin May Not Be Useful for Post–Cardiac Arrest Decision Making

Guidelines recommend early coronary angiography for survivors of cardiac arrest, but identifying the patients who may benefit most, or not at all, is challenging. Although troponin is frequently measured after cardiac arrest, the utility of an elevated troponin to identify patients with a likely cardiac cause of arrest is unknown.

These researchers retrospectively reviewed records for 145 survivors of in-hospital or out-of-hospital cardiac arrest who underwent serial troponin measurements and transthoracic echocardiography at a single academic medical center. Cases were adjudicated by experts to determine cardiac etiology.

None of four troponin cutoff levels analyzed — ranging from 1 to 1000 times the upper limit of normal — had adequate sens…