Prognostic value of cardiac troponin in elderly patients with paroxysmal supraventricular tachycardia: A multicenter study.

BACKGROUND: An elevated level of cardiac troponin I (cTnI) frequently accompanies an episode of supraventricular tachycardia (SVT). However, the predictive value of cTnI in elderly SVT patients has not been examined. METHODS: We collected the electronic medical records of elderly SVT patients (over 65 years old) who visited four Taiwanese emergency departments over a 2-year period. The patients who underwent cTnI testing were included in the cohort and further categorized based on their cTnI results (positive or negative). The study's primary outcomes were the 5-year risks of major adverse cardiovascular events (MACE) and SVT recurrence. RESULTS: One hundred and twenty-four patients met the inclusion criteria. Of these patients, 39 (31.5%) had a positive cTnI result, and 85 (68.5%) had a negative cTnI result. Patients with a positive cTnI result were older (p = 0.029) and had a longer hospital stay (p = 0.023) than those with a negative cTnI result. Multivariate analysis showed that age > 75 years (OR = 2.41; 95% CI 1.07-5.45; p = 0.034) was an independent predictor for cTnI elevation. In the survival analysis, no difference in the incidence of five-year MACE (p = 0.656) was observed between the cTnI-positive and cTnI-negative groups. Multivariate analysis revealed that a history of coronary artery disease was the only significant independent risk factor for MACE (HR = 4.30; 95% 95% CI 1.41-13.05; p = 0.010). For SVT recurrence, the multivariate analysis revealed that previous SVT (HR = 3.37; 95% CI 1.53-7.39; p = 0.002), smoking history (HR = 2.32; 95% CI 1.03-5.24; p = 0.043), and RFA treatment (HR = 0.20; 95% CI 0.06-0.65; p = 0.008) were significant independent predictors. CONCLUSIONS: An increased cardiac troponin level may not effectively indicate the risk of MACE in elderly SVT patients. Physicians might want to be cautious when interpreting troponin test results for this specific patient group.

Strategic planning to reduce conflicts for offshore wind development in Taiwan: A social marketing perspective.

This study aims to improve the current inefficiency and ineffectiveness of communications among stakeholders when planning and constructing offshore wind farms (OWFs). An analysis using a social marketing approach with segmentation techniques is used to identify the target market based on stakeholders' perceptions. The empirical results identify three stakeholder segments: (1) impact-attend group; (2) comprehensive group; and (3) benefit-attend group. The results suggest that communication should be implemented to alter stakeholders' attitudes toward the construction of OWFs. Furthermore, based on the results of segmentation, target markets are identified to plan the communication strategies for reducing the conflicts among stakeholders of OWF construction. The results also indicated that in the planning phase of construction for OWFs, effective stakeholder participation and policy communication can enhance the perception of benefits to reduce conflict with local communities and ocean users.