Cardiac troponin I as a prognostic factor in critically ill pneumonia patients in the absence of acute coronary syndrome

Lee, Yeon Joo; Lee, Hongyeul; Park, Ji Soo; Kim, Sejoong; Cho, Young Jae; Yoon, Ho Il; Lee, Jae-Ho; Lee, Choon Taek

doi:10.1016/j.jcrc.2014.12.001

Cited by 31 publications

(32 citation statements)

References 27 publications

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“…The prognosis of these patients in the absence of ACS is less certain, and in recent years, there has been increasing interest in quantifying the prognostic value of cTnI in this setting. Examples of this emerging role for cTnI include recent work showing that the cTnI assay is a useful independent predictor of mortality in patients hospitalised with severe pneumonia [3] and sepsis [4], as well as in prognosticating the risk of long-term cardiac outcomes following acute stroke [5]. …”

Section: Introductionmentioning

confidence: 99%

Incidentally Raised Cardiac Troponin I Has a Worse Prognosis in Older Patients Compared to Those with Normal Cardiac Troponin I and Patients with Acute Coronary Syndrome: A Cohort Study

et al. 2016

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Background: Incidentally elevated cardiac troponin I (cTnI) levels are common in acutely unwell older patients. However, little is known about how this impacts on the prognosis of these patients. Objective: We aimed to investigate whether incidentally elevated cTnI levels (group 1) are associated with poorer outcome when compared to age- and sex-matched patients without an elevated cTnI level (group 2), and to patients diagnosed with acute coronary syndrome (group 3). Patients and Methods: This prospective, matched cohort study placed patients ≥75 years old who were admitted to a University teaching hospital into groups 1-3, based on the cTnI levels and underlying diagnosis. Outcomes were compared between the groups using mixed-effects regression models and adjusted for renal function and C-reactive protein. All-cause mortality at discharge, at 1 month and 3 months, alongside the length of hospital stay (LOS), were recorded. Results: In total, 315 patients were included, with 105 patients in each of the 3 groups. The mean age was 84.8 ± 5.5 years, with 41.9% males. All patients were followed up for 3 months. The percent all-cause mortality at discharge and the LOS for groups 1, 2 and 3 were 12.4, 3.8 and 8.6% and 11.2, 8.5 and 7.7 days, respectively. Group 1 had significantly increased mortality at 3 months [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.12-6.96; p = 0.040] and LOS (OR 1.39, 95% CI 1.08-1.79; p = 0.008) compared to group 2 and did not differ significantly when compared to 3-month mortality (OR 2.39, 95% CI 0.91-6.29; p = 0.079) or LOS (OR 1.26, 95% CI 0.96-1.66; p = 0.097) in group 3. Conclusion: There is a significant association between an incidental rise in cTnI level with mortality and LOS in older patients. Further research is required to evaluate whether a more systematic management of these patients would improve the prognosis.

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Section: Introductionmentioning

confidence: 99%

Incidentally Raised Cardiac Troponin I Has a Worse Prognosis in Older Patients Compared to Those with Normal Cardiac Troponin I and Patients with Acute Coronary Syndrome: A Cohort Study

et al. 2016

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“…Among these, only a history of coronary artery disease, smoking, and acute disease severity (APACHE) could be confirmed in our study. This might be explained by the fact that many studies did not perform multivariable adjustment [8,9,24], or were conducted in a clinical domain that…”

Section: Discussionmentioning

confidence: 99%

Myocardial injury in critically ill patients with community-acquired pneumonia

Frencken

Baal

Kappen

et al. 2017

Preprint

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“…Cardiac troponins are biomarker for myocardial injury and together with BNP have been demonstrated to provide independent prognostic information in patients hospitalized with acute coronary syndromes. 3 As cardiac troponin can be used to stratify risk in patients with pneumonia 4,5 we hypothesized there is a good correlation between NT-pro-BNP as a reliable marker of myocardial stress and also of sepsis-induced myocardial depression and the pneumonia illness scores NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia N o n -c o m m e r c i a l u s e o n l y PSI and CURB-65. Moreover, we were also interested in evaluating any correlation with procalcitonin (PCT), well-known biomarker of sepsis due to bacterial sustained infection.…”

Section: Introductionmentioning

confidence: 99%

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

et al. 2017

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Pneumonia severity index (PSI) and urea, respiratory rate, blood pressure, age ≥65) are used to estimate the severity and prognosis of patients with pneumonia. NT-proBNP is a marker of myocardial stress and of sepsis-induced myocardial depression and might be used to predict short and long-term survival in patients with pneumonia. Twenty-three patients [age 79±15 standard deviation (SD); M/F 8/15, CURB-65 2.2±0.9 SD, PSI 118±38 SD, procalcitonin 3.9±5 SD] with pneumonia hospitalized in our Internal Medicine Unit were retrospectively evaluated. NT-proBNP was measured in the first 72 h of hospitalization. CURB-65 and PSI were calculated and correlation with biomarkers investigated. NT-proBNP showed a moderate statistically significant correlation with both PSI and CURB-65 (NT-proBNP vs PSI, r=0.42, P<0.05, NT-proBNP vs CURB-65, r=0.46, P<0.05). These correlations were confirmed also when patients with a diagnosis of heart failure where excluded from the analysis, even if the correlation did not reach the statistical significance. NT-proBNP seems to well correlate with the illness scores PSI and CURB-65 and might be a reliable predictor of severity and survival in patients with pneumonia.

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Cardiac troponin I as a prognostic factor in critically ill pneumonia patients in the absence of acute coronary syndrome

Cited by 31 publications

References 27 publications

Incidentally Raised Cardiac Troponin I Has a Worse Prognosis in Older Patients Compared to Those with Normal Cardiac Troponin I and Patients with Acute Coronary Syndrome: A Cohort Study

Incidentally Raised Cardiac Troponin I Has a Worse Prognosis in Older Patients Compared to Those with Normal Cardiac Troponin I and Patients with Acute Coronary Syndrome: A Cohort Study

Myocardial injury in critically ill patients with community-acquired pneumonia

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

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