Evaluation of cardiac troponin I as a predictor of death in critically ill cats

Pelander, Lena; Bach, Maiken Bayer Thode; Ljungvall, Ingrid; Willesen, Jakob L.; Koch, J.; Dreimanis, Kristoffer; Telling, Amalie; Damsgard, Rikke M; Ohlsson, Åsa; Häggström, Jens; Langhorn, Rebecca

doi:10.1111/jvim.16635

Cited by 3 publications

(1 citation statement)

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“…In veterinary medicine, a high serum concentration of cTnI is reported as a negative prognostic marker of death in dogs affected with SIRS [ 42 , 43 , 44 ]. Significantly higher levels of cTnI have been assayed also in cats with hypertrophic cardiomyopathy [ 45 , 46 , 47 ] and no specific primary cardiac diseases such as hyperthyroidism [ 48 ], renal disease [ 23 ], critical illness [ 48 , 49 ], and hypertension [ 50 ]. This study showed that an increase in cTnI suggesting the presence of myocardial injury is common in cats affected with SIRS, similarly to dogs [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Troponin I and Electrocardiographic Evaluation in Hospitalized Cats with Systemic Inflammatory Response Syndrome

Pugliese,

Napoli,

La Maestra

et al. 2023

Veterinary Sciences

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Several studies conducted on humans demonstrate the increase in cardiac troponins and the onset of arrhythmias in the course of systemic inflammatory response syndrome (SIRS). The aim of the current study was to assess the blood concentration of cardiac troponin I (cTnI) and electrocardiographic findings in SIRS-affected cats. Seventeen shorthair cats hospitalized with SIRS were enrolled (Group 1). SIRS diagnosis was performed based on the detection of at least two of the four criteria such as abnormal body temperature, abnormal heart rate (i.e., tachycardia or bradycardia), abnormal respiratory rate (i.e., tachypnea or bradypnea), and alterations of white blood cell number (i.e., leukocytes or band neutrophils). Ten cats screened for elective surgery such as neutering or dental procedures were evaluated as a control population (Group 2). They were considered healthy based on history, physical examination, hematological and biochemical profile, urinalysis, coprological exam, thyroxine assay, blood pressure measurement, and echocardiography. A physical examination, complete blood cell count, biochemistry test (including an electrolyte panel), electrocardiographic examination, and cTnI assay were carried out in each cat enrolled. Traumatic events, gastrointestinal, neoplastic, respiratory, and neurological disorders were identified as causes of SIRS in Group 1. In Group 1, a significantly higher concentration of cTnI than that in Group 2 was recorded (p = 0.004). In 37.5% of cats with SIRS, ventricular premature complexes occurring in couplets with multiform configuration were detected. Similarly, to humans, data herein reported would indicate possible cardiac damage present in cats with SIRS diagnosis.

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Section: Discussionmentioning

confidence: 99%

Cardiac Troponin I and Electrocardiographic Evaluation in Hospitalized Cats with Systemic Inflammatory Response Syndrome

Pugliese,

Napoli,

La Maestra

et al. 2023

Veterinary Sciences

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Evaluation of cardiac troponin I as a predictor of death in critically ill cats

Pelander

Bach

Ljungvall

et al. 2023

Veterinary Internal Medicne

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Background Abnormally high serum cardiac troponin I (cTnI) concentration, reflecting leakage from or necrosis of cardiomyocytes, is a negative prognosticator for death in dogs. Objectives To investigate in critically ill cats whether serum cTnI concentration is abnormally high, identify conditions associated with abnormally high cTnI concentrations, and evaluate cTnI as an independent prognosticator for death and a potential coprognosticator to the acute patient physiologic and laboratory evaluation (APPLE) score in cats. Animals One hundred nineteen cats admitted to intensive care units (ICU) and 13 healthy cats at 2 university teaching hospitals. Methods Prospective study. Clinical examinations were performed, APPLE scores calculated, and serum cTnI and serum amyloid A (SAA) measured within 24 hours after admission. Outcome was defined as death/euthanasia or survival to discharge, 28 and 90 days after ICU‐admission. Prognostic capacity of cTnI, APPLE scores and models combining cTnI and scores were evaluated by receiver‐operator‐characteristic analyses. Results Median (IQR) serum cTnI concentration was higher in ill (0.63 [0.18‐2.65] ng/mL) compared to healthy (0.015 [0.005‐0.041] ng/mL) cats ( P < .001) and higher in subgroups with structural cardiac disease (2.05 [0.54‐16.59] ng/mL; P < .001) or SAA >5 mg/L (0.84 [0.23‐2.81] ng/mL; P = .009) than in cats without these characteristics (0.45 [0.12‐1.70] and 0.35 [0.015‐0.96] ng/mL). The in‐hospital case fatality rate was 29%. Neither serum cTnI concentration for all critically ill cats (area‐under‐the‐curve 0.567 [95% CI 0.454‐0.680], n = 119) or subgroups (0.625 [0.387‐0.863], n = 27; 0.506 [0.360‐0.652], n = 86), nor APPLE scores (fast 0.568 [0.453‐0.682], full 0.585 [0.470‐0.699], n = 100), were significant prognosticators for death. Conclusions and Clinical Importance Abnormally high serum cTnI concentration was common in critically ill cats. Unlike in dogs, cTnI did not confer prognostic information regarding death.

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Feline acute patient physiologic and laboratory evaluation scores and other prognostic factors in cats with first‐time diabetic ketoacidosis

Ad,

Hess

2024

Veterinary Internal Medicne

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BackgroundAcute Patient Physiologic and Laboratory Evaluation (APPLE) scores have not been reported in cats with diabetic ketoacidosis (DKA).HypothesisIn cats with DKA, APPLE scores will be significantly higher in non‐survivors compared with survivors and these scores will predict mortality.AnimalsSixty‐eight cats with DKA.MethodsRetrospective study. The APPLE scores, blood glucose concentration (BG), venous pH, and ketone concentrations were compared between survivors and non‐survivors. Simple logistic regression was used to determine if these variables predict the binary variable of survival or non‐survival, and if they did, an empirical optimal cut point for mortality prediction was calculated.ResultsThe APPLEfast and APPLEfull scores were significantly higher in non‐survivors (30 cats; and , respectively) compared with survivors (38 cats; and ; P = .01 and P = .02, respectively). The APPLEfast (P = .03) but not the APPLEfull scores (P = .06) predicted mortality. For every 1 unit increase in the APPLEfast score, the odds of death increased by 1.08 (95% confidence interval [CI], 1.006‐1.17; P = .03). Median BG was significantly higher in non‐survivors (431 mg/dL; range, 260‐832 mg/dL) compared with survivors (343 mg/dL; range, 256‐738 mg/dL; P = .01) and BG predicted mortality (P = .02). For every 1 mg/dL increase in BG, the odds of death increased by 1.004 (95% CI, 1.0006‐1.008). Empirical optimal cut points for APPLEfast and BG mortality prediction were 24.5 and 358 mg/dL, respectively.Conclusions and Clinical ImportanceThe APPLEfast score and BG predict mortality in cats with DKA and can be used to stratify populations by risk of mortality in clinical trials of DKA in cats.

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Evaluation of cardiac troponin I as a predictor of death in critically ill cats

Cited by 3 publications

References 43 publications

Cardiac Troponin I and Electrocardiographic Evaluation in Hospitalized Cats with Systemic Inflammatory Response Syndrome

Cardiac Troponin I and Electrocardiographic Evaluation in Hospitalized Cats with Systemic Inflammatory Response Syndrome

Evaluation of cardiac troponin I as a predictor of death in critically ill cats

Feline acute patient physiologic and laboratory evaluation scores and other prognostic factors in cats with first‐time diabetic ketoacidosis

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