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

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...

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Detalles Bibliográficos
Autores principales: Pelander, Lena, Bach, Maiken B. T., Ljungvall, Ingrid, Willesen, Jakob L., Koch, Jörgen, Dreimanis, Kristoffer, Telling, Amalie, Damsgard, Rikke M., Ohlsson, Åsa, Häggström, Jens, Langhorn, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2023
Materias:
SMALL ANIMAL
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10061183/
https://www.ncbi.nlm.nih.gov/pubmed/36708236
http://dx.doi.org/10.1111/jvim.16635
Descripción
Sumario: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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