Absolute change in hs-cTnI and relative change in hs-cTnI within both 24 h and 48 h in addition to elevated creatinine were strong predictors of in-hospital mortality, after adjustment for sex, time from onset to hospital admission, occurrence of ventricular tachycardia and ventricular fibrillation (hs-cTnIΔ24h > − 618 ng/l: HR = 6.93 [1.88–25.64], P = 0.004; hs-cTnIΔ48h > − 4389 ng/l: HR = 6.47 [1.29–32.42], P = 0.023; hs-cTnIΔ%24 h > − 28.46%: HR = 13.83 [1.76–108.95], P = 0.013; hs-cTnIΔ%48 h > − 52.23%: HR = 19.88 [2.40–164.79], P = 0.006). Here, TNNI3 is linked to ventricular fibrillation.