Although the measurement of cardiac troponin I (cTnI) and T (cTnT) has now become the cornerstone for diagnosing cardiac injury, both ischemic and non-ischemic, recent evidence has become available that many patients display extra-cardiac causes of cTn elevations and carry a considerably enhanced risk of future mortality. The current literature data suggests that cTn elevations may be equally common in patients with cardiac and extra-cardiac diseases. Among the latter cohort of patients, the leading extra-cardiac diseases which may be responsible for either cTnI or cTnT elevations include infectious diseases/sepsis, pulmonary disorders, renal failure, malignancy, as well as gastrointestinal, neurological and musculoskeletal diseases. What also emerges rather clearly from the current literature data, is that the risk of dying for extra-cardiac diseases is higher (i.e., between two to three-fold) in patients with extra-cardiac cTn elevations than in those with cardiac pathologies, and that the most frequent cause of death would then be infections/sepsis, followed by malignancy, respiratory disorders, myocardial infarction, gastrointestinal and neurological diseases, heart failure, stroke, cardiac arrhythmias, renal failure, psychiatric, metabolic, urogenital and musculoskeletal disorders. These figures would lead to conclude that there is a considerable risk that the underlying pathology causing cardiac injury and cTn elevation would then become the cause of death in these patients. This important evidence shall lead the way to defining appropriate and effective strategies for managing patients with extra-cardiac cTn elevations, so that their risk of future death could be prevented or limited.

中文翻译：

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探索心外肌钙蛋白升高与未来死亡风险之间的关联。

虽然心肌肌钙蛋白 I (cTnI) 和 T (cTnT) 的测量现在已成为诊断心脏损伤的基石，包括缺血性和非缺血性，但最近的证据表明，许多患者表现出 cTn 升高的心外原因并携带未来死亡的风险大大增加。目前的文献数据表明，cTn 升高在患有心脏和心脏外疾病的患者中可能同样常见。在后一组患者中，可能导致 cTnI 或 cTnT 升高的主要心脏外疾病包括传染病/败血症、肺部疾病、肾衰竭、恶性肿瘤以及胃肠道、神经系统和肌肉骨骼疾病。从当前的文献数据中也可以清楚地看到，心脏外 cTn 升高的患者死于心脏外疾病的风险高于心脏病患者（即 2 到 3 倍），并且最常见的死亡原因是感染/败血症，其次是恶性肿瘤、呼吸系统疾病、心肌梗塞、胃肠道和神经系统疾病、心力衰竭、中风、心律失常、肾功能衰竭、精神疾病、代谢疾病、泌尿生殖系统疾病和肌肉骨骼疾病。这些数字将得出结论，即导致心脏损伤和 cTn 升高的潜在病理学将成为这些患者死亡的原因的风险相当大。这一重要证据将引导确定适当和有效的策略来管理心脏外 cTn 升高的患者，