Dear Editor,

We read the article published by Attanasio et al. [1] with great interest that points out the prognostic value of cardiac troponin I (cTnI) for mortality risk especially 6 months after hospital discharge. It is very important to determine the parameters that affect mortality. But, there are some points that should be addressed.

Cardiovascular comorbidities were found to be more common in cTnI positive patients. At 6 months, cTnI positivity seemed as a mortality risk factor but it was unclear whether these comorbidities were more common in the patients that died. Additionally, although the authors mentioned that in multidimensional assessments cTnI could contribute the mortality risk, we couldn’t see any regression analyses results that take into account these comorbidities. Furthermore, after adjusting the HR the relationship became non-significant. Our second concern is that the time passed between the initiation of the symptoms and admission to emergency service was unclear. Variability in this length could affect the cTnI levels.

Further studies in the light of these recommendations will clarify the relationship between cTnI and mortality risk with better accuracy.