King's College London

Research portal

Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness

Research output: Contribution to journalArticle

Marlies Ostermann, Salma Ayis, Emma Tuddenham, Jessica Lo, Katie Lei, John Smith, Barnaby Sanderson, Carl Moran, Paul Collinson, Janet Peacock, Andrew Rhodes, David Treacher

Original languageEnglish
JournalShock
DOIs
Publication statusAccepted/In press - 29 Nov 2016

King's Authors

Abstract

INTRODUCTION: Troponin release is common during critical illness. We hypothesized that there was an association between cardiac troponin T (cTnT) and biomarkers of systemic inflammation and ventricular dilatation.

METHODS: In an observational prospective cohort study, we enrolled consecutive adult patients admitted for non-cardiac reasons to the Intensive Care Unit (ICU) in 2 tertiary care centers. We measured cTnT, C-reactive protein (CRP), Interleukin-6 (IL-6), procalcitonin (PCT) and N-terminal pro brain natriuretic peptide (NT-proBNP) daily in the first week, and on alternate days in the second week. Using a peak cTnT cut-off ≥15ng/L and concomitant changes on electrocardiogram (ECG), patients were categorised as "definite myocardial infarction (MI)", "possible MI", "cTnT rise only" or "no cTnT rise". Within each group, associations between CRP, IL-6, PCT, NT-proBNP and cTnT were investigated using mixed effect models.

RESULTS: 172 patients were included in the analysis of whom 84% had a cTnT rise ≥15ng/L. 21 patients (12%) had a definite MI, 51 (30%) had a possible MI and 73 (42%) had a cTnT rise only. At time of peak cTnT, 71% of patients were septic and 67% were on vasopressors.Multivariable analysis showed a significant association between cTnT and IL-6 in all patients with a cTnT rise independent of age, gender, renal function and cardiovascular risk factors. In patients without a definite MI, cTnT levels were significantly associated with PCT and NT-proBNP values. In patients without elevated cTnT levels, there was no associated NT-proBNP rise.

CONCLUSIONS: In ICU patients admitted for non-cardiac reasons, serial cTnT levels were independently associated with markers of systemic inflammation and NT-proBNP.

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454