Methods: Between October 1st, 2016 and April 30th, 2019, a total of 5,079 patients (2,844 males, 2,235 females; median age: 65 years; range, 49 to 83 years) who presented to the emergency department with chest pain and whose troponin and creatinine measurements were done were retrospectively analyzed. Laboratory data and 28-day mortality rates were evaluated. The patients were divided into two groups according to 28-day mortality rates after the initial emergency department admission as survivors (n=4,793) and non-survivors (n=286).

Results: There were statistically significant differences in the white blood cell count, C-reactive protein, creatinine, high-sensitivity troponin I, and troponin/creatinine ratio between the groups (p<0.05). The high-sensitivity troponin I ?31.96 pg/dL, creatinine ?1.11 mg/dL, C-reactive protein ?43.94 mg/L, and troponin/creatinine ratio ?25.12 were independent predictors of 28-day mortality (p<0.05). A C-reactive protein value of ?43.94 mg/L was found to be more specific (81.14%) than the other markers for mortality.

Conclusion: Troponin/creatinine ratio is a predictor of mortality in patients presenting to the emergency department with chest pain and high-sensitivity troponin I, creatinine, and C-reactive protein seem to be independent risk factors for 28-day mortality.