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Background One-year all-cause mortality following hospital admission is 9–12% in adults over 70 years. 1 Elevated NT-proB-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT) are prognostic markers in cardiac disease but their predictive power in broader populations remains uncertain.Aim To assess prognostic value of elevated hs-TnT and NT-proBNP in acute medical admissions without ACS, heart failure, or valve disease.Methods We conducted a single-centre retrospective analysis of 184,232 emergency admissions over 21 years. hs-TnT and NT-proBNP were measured in 12.9% and 11.7% of patients, respectively. Biomarker status was categorised as: neither elevated, troponin only, NT-proBNP only, or both elevated. Primary outcome was 30-day mortality; secondary outcome was survival to 80 months. Logistic regression adjusted for age, comorbidity, and Acute Illness Severity Score. Cox models assessed long-term survival.Results NT-proBNP testing increased from 19.9% to 27.6% (p<0.001). Among 58,439 patients (105,173 admissions), those tested were older (median 73.2 vs. 61.1 years, p<0.001), stayed longer (8.0 vs. 3.3 days, p<0.001), and had higher 30-day mortality (7.8% [95% CI 7.4–8.3] vs. 2.4% [95% CI 2.3–2.5]). NT-proBNP ≥250 pg/mL was associated with mortality (OR 6.4, 95% CI 5.6–7.1); adjusted OR for 30-day mortality was 1.70 (95% CI 1.55–1.86). Of 8,175 deaths (13.9%), 3,808 occurred in-hospital and 4,367 post-discharge (mean 24.1 months).hs-TnT was measured in 27,254 patients (23.5%), declining from 29.5% to 20% over 21 years. Elevated hs-TnT conferred increased risk (OR 5.5, 95% CI 5.1–6.9), especially >50 ng/mL (OR 10.1–12.0). Post-discharge mortality was 8% (n=5,447) at 27 months.In the combined cohort, 30-day mortality increased stepwise: troponin only (OR 1.97, 95% CI 1.82–2.13), NT-proBNP only (OR 2.08, 95% CI 1.94–2.23), and both elevated (OR 3.54, 95% CI 3.26–3.83).Conclusion In non-ACS admissions, hs-TnT and NT-proBNP independently predicted mortality, with greatest risk when both biomarkers were elevated.