Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome

Røsjø, Helge; Varpula, Marjut; Hagve, Tor‐Arne; Karlsson, Sari; Ruokonen, Esko; Pettilä, Ville; Omland, Torbjørn

doi:10.1007/s00134-010-2051-x

Cited by 153 publications

(127 citation statements)

References 39 publications

(52 reference statements)

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“…However, only 3 studies used TnT values 2. By contrast, other investigators have failed to validate troponin as an independent predictor of mortality in addition to severity of illness scores 9, 27, 28, 29…”

Section: Discussionmentioning

confidence: 99%

Role of Admission Troponin‐T and Serial Troponin‐T Testing in Predicting Outcomes in Severe Sepsis and Septic Shock

Vallabhajosyula

Sakhuja

Geske

et al. 2017

JAHA

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BackgroundTroponin‐T elevation is seen commonly in sepsis and septic shock patients admitted to the intensive care unit. We sought to evaluate the role of admission and serial troponin‐T testing in the prognostication of these patients.Methods and ResultsThis was a retrospective cohort study from 2007 to 2014 on patients admitted to the intensive care units at the Mayo Clinic with severe sepsis and septic shock. Elevated admission troponin‐T and significant delta troponin‐T were defined as ≥0.01 ng/mL and ≥0.03 ng/mL in 3 hours, respectively. The primary outcome was in‐hospital mortality. Secondary outcomes included 1‐year mortality and lengths of stay. During this 8‐year period, 944 patients met the inclusion criteria with 845 (90%) having an admission troponin‐T ≥0.01 ng/mL. Serial troponin‐T values were available in 732 (78%) patients. Elevated admission troponin‐T was associated with older age, higher baseline comorbidity, and severity of illness, whereas significant delta troponin‐T was associated with higher severity of illness. Admission log10 troponin‐T was associated with unadjusted in‐hospital (odds ratio 1.6; P=0.003) and 1‐year mortality (odds ratio 1.3; P=0.04), but did not correlate with length of stay. Elevated delta troponin‐T and log10 delta troponin‐T were not significantly associated with any of the primary or secondary outcomes. Admission log10 troponin‐T remained an independent predictor of in‐hospital mortality (odds ratio 1.4; P=0.04) and 1‐year survival (hazard ratio 1.3; P=0.008).ConclusionsIn patients with sepsis and septic shock, elevated admission troponin‐T was associated with higher short‐ and long‐term mortality. Routine serial troponin‐T testing did not add incremental prognostic value in these patients.

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Section: Discussionmentioning

confidence: 99%

Role of Admission Troponin‐T and Serial Troponin‐T Testing in Predicting Outcomes in Severe Sepsis and Septic Shock

Vallabhajosyula

Sakhuja

Geske

et al. 2017

JAHA

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“…1) (13). Four hundred seventy patients were included, and blood samples were available from 232 patients at ICU admission (median, 9 [Q1-Q3, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] hr from study inclusion to sampling) and from 201 patients after 72 hours.…”

Section: Methodsmentioning

confidence: 99%

“…We measured NT-proBNP by the Elecsys proBNP assay (Roche Diagnostics, Penzberg, Germany) (4) and chromogranin A (CgA) by a commercially available radioimmunoassay (EuroDiagnostica, Malmö, Sweden) (15). hs-TnT levels were measured by the Elecsys TNT hs STAT assay (Roche Diagnostics) in a subgroup of the patients with severe sepsis (n = 207) as previously reported (5). Cortisol was measured by an immunoassay in the patients who had not received corticosteroids prior to blood sampling, and free cortisol was calculated by the Coolens method (16).…”

Section: Biochemical Analysesmentioning

confidence: 99%

“…Cardiovascular biomarkers could prove useful for early risk assessment in critically ill patients with infections, but the established biomarkers N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT) seem to lack the desired prognostic accuracy when measured at ICU admission (4,5). Accordingly, novel cardiovascular biomarkers are needed to improve the risk assessment on ICU admission.…”

mentioning

confidence: 99%

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Prognostic Value of Secretoneurin in Critically Ill Patients With Infections

Røsjø

Stridsberg

Ottesen

et al. 2016

Critical Care Medicine

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1Objectives : Secretoneurin is produced in neuroendocrine cells, and the myocardium and circulating secretoneurin levels provide incremental prognostic information to established risk indices in cardiovascular disease. As myocardial dysfunction contributes to poor outcome in critically ill patients, we wanted to assess the prognostic value of secretoneurin in two cohorts of critically ill patients with infections. Design: Two prospective, observational studies. Setting: Twenty-four and twenty-five ICUs in Finland. Patients: A total of 232 patients with severe sepsis (cohort #1) and 94 patients with infections and respiratory failure (cohort #2). Interventions: None. Measurements and Main Results: We measured secretoneurin levels by radioimmunoassay in samples obtained early after ICU admission and compared secretoneurin with other risk indices. In patients with severe sepsis, admission secretoneurin levels (logarithmically transformed) were associated with hospital mortality (odds ratio, 3.17 [95% CI, 1.12-9.00]; p = 0.030) and shock during the hospitalization (odds ratio, 2.17 [1.06-4.46]; p = 0.034) in analyses that adjusted for other risk factors available on ICU admission. Adding secretoneurin levels to age, which was also associated with hospital mortality in the multivariate model, improved the risk prediction as assessed by the category-free net reclassification index: 0.35 (95% CI, 0.06-0.64) (p = 0.02). In contrast, N-terminal pro-B-type natriuretic peptide levels were not associated with mortality in the multivariate model that included secretoneurin measurements, and N-terminal pro-B-type natriuretic peptide did not improve patient classification on top of age. Secretoneurin levels were also associated with hospital mortality after adjusting for other risk factors and improved patient classification in cohort #2. In both cohorts, the optimal cutoff for secretoneurin levels at ICU admission to predict hospital mortality was ≈ 175 pmol/L, and higher levels were associated with mortality also when adjusting for Simplified Acute Physiology Score II and Sequential Organ Failure Assessment scores. Conclusions: Secretoneurin levels provide incremental information to established risk indices for the prediction of mortality and shock in critically ill patients with severe infections. (Crit Care Med 2016; XX:00-00)

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“…In addition, it is a useful prognostic predictor independent of left ventricular ejection fraction or B-type natriuretic peptide in patients with congestive HF and non-ischemic dilated cardiomyopathy. In sepsis, measurements of circulating hs-cTnT may be an early marker for shock (Røsjø et al, 2011). These results demonstrate that hs-cTnT is a much more sensitive and timely detector for AMI than cTnT.…”

Section: Discussionmentioning

confidence: 99%

High-sensitivity cardiac troponin T is a predictor of recurrent acute coronary syndrome in patients with acute myocardial infarction

Sheng

Kang

et al. 2014

Genet. Mol. Res.

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ABSTRACT. High-sensitivity cardiac troponin T is a useful tool for diagnosing myocardial ischemia. However, its role in the prognosis of patients with acute myocardial infarction has not been studied. Here, the prognostic value of high-sensitivity cardiac troponin T for patients with acute myocardial infarction was investigated. The concentrations of high-sensitivity cardiac troponin T, other clinical chemistry makers, and living habits were investigated at the time of admission in patients with acute coronary syndrome, whereas the high-sensitivity cardiac troponin T concentrations at 6 h after admission and during recovery were analyzed in other patient groups. The concentration of high-sensitivity cardiac troponin T was significantly higher in patients with acute myocardial infarction than in those with other cardiac diseases and in controls (P < 0.01). Based on the standard diagnostic criterion, 134 patients were diagnosed with acute myocardial infarction. Monitoring the change in concentration of high-sensitivity cardiac troponin T in patients with acute coronary syndrome can reduce the risk of recurrence and death.

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Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome

Cited by 153 publications

References 39 publications

Role of Admission Troponin‐T and Serial Troponin‐T Testing in Predicting Outcomes in Severe Sepsis and Septic Shock

Role of Admission Troponin‐T and Serial Troponin‐T Testing in Predicting Outcomes in Severe Sepsis and Septic Shock

Prognostic Value of Secretoneurin in Critically Ill Patients With Infections

High-sensitivity cardiac troponin T is a predictor of recurrent acute coronary syndrome in patients with acute myocardial infarction

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