患有恶性肿瘤的患者心肌肌钙蛋白通常会升高。肌钙蛋白升高对这些患者的预后意义尚不清楚。我们试图在一个大型、特征明确的患者队列中研究肌钙蛋白与死亡率之间的关系，这些患者定期测量肌钙蛋白并初步诊断为恶性肿瘤。我们使用了美国国立卫生研究院的数据研究 (NIHR) 健康信息学合作数据涉及 5571 名患者，这些患者于 2010 年至 2017 年间在英国 5 个心脏中心测量了肌钙蛋白水平，并初步诊断为恶性肿瘤。患者被分为实体瘤或血液恶性肿瘤亚组。峰值肌钙蛋白水平被标准化为每个实验室的正常值 99% 上限 (xULN) 的倍数。4649 名患者被诊断患有实体瘤，922 名患者被诊断患有血液恶性肿瘤。肌钙蛋白升高是所有患者（肌钙蛋白 > 10与<1调整后HR 2.01，95% CI 1.73至2.34）、实体瘤（HR 1.84，95% CI 1.55至2.19）和血液恶性肿瘤患者死亡率的独立预测因子（HR 2.72，95% CI 1.99 至 3.72）。在所有三个亚组中，肌钙蛋白类别的死亡风险均呈显着增加趋势 (p<0.001)。无论癌症亚型如何，肌钙蛋白水平升高与初次诊断为恶性肿瘤的患者死亡率增加相关。对于肌钙蛋白水平低于 ULN 的患者，死亡风险是稳定的，但在不存在急性冠状动脉综合征的情况下，随着肌钙蛋白水平升高至高于 ULN，死亡风险会增加。© 2024。作者。

Cardiac troponin is commonly raised in patients presenting with malignancy. The prognostic significance of raised troponin in these patients is unclear.We sought to investigate the relation between troponin and mortality in a large, well characterised cohort of patients with a routinely measured troponin and a primary diagnosis of malignancy.We used the National Institute for Health Research (NIHR) Health Informatics Collaborative data of 5571 patients, who had troponin levels measured at 5 UK cardiac centres between 2010 and 2017 and had a primary diagnosis of malignancy. Patients were classified into solid tumour or haematological malignancy subgroups. Peak troponin levels were standardised as a multiple of each laboratory's 99th -percentile upper limit of normal (xULN).4649 patients were diagnosed with solid tumours and 922 patients with haematological malignancies. Raised troponin was an independent predictor of mortality in all patients (Troponin > 10 vs. <1 adjusted HR 2.01, 95% CI 1.73 to 2.34), in solid tumours (HR 1.84, 95% CI 1.55 to 2.19), and in haematological malignancy (HR 2.72, 95% CI 1.99 to 3.72). There was a significant trend in increasing mortality risk across troponin categories in all three subgroups (p < 0.001).Raised troponin level is associated with increased mortality in patients with a primary diagnosis of malignancy regardless of cancer subtype. Mortality risk is stable for patients with a troponin level below the ULN but increases as troponin level increases above the ULN in the absence of acute coronary syndrome.© 2024. The Author(s).