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

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 p...

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Autores principales: Ostermann, Marlies, Ayis, Salma, Tuddenham, Emma, Lo, Jessica, Lei, Katie, Smith, John, Sanderson, Barnaby, Moran, Carl, Collinson, Paul, Peacock, Janet, Rhodes, Andrew, Treacher, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419814/
https://www.ncbi.nlm.nih.gov/pubmed/27902530
http://dx.doi.org/10.1097/SHK.0000000000000811
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author Ostermann, Marlies
Ayis, Salma
Tuddenham, Emma
Lo, Jessica
Lei, Katie
Smith, John
Sanderson, Barnaby
Moran, Carl
Collinson, Paul
Peacock, Janet
Rhodes, Andrew
Treacher, David
author_facet Ostermann, Marlies
Ayis, Salma
Tuddenham, Emma
Lo, Jessica
Lei, Katie
Smith, John
Sanderson, Barnaby
Moran, Carl
Collinson, Paul
Peacock, Janet
Rhodes, Andrew
Treacher, David
author_sort Ostermann, Marlies
collection PubMed
description 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 noncardiac reasons to the intensive care unit (ICU) in two 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 cutoff ≥15 ng/L and concomitant changes on electrocardiogram, patients were categorized 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: One hundred seventy-two patients were included in the analysis of whom 84% had a cTnT rise ≥15 ng/L. Twenty-one patients (12%) had a definite MI, 51 (30%) had a possible MI, and 73 (42%) had a cTnT rise only. At the 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.
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spelling pubmed-54198142017-05-22 Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness Ostermann, Marlies Ayis, Salma Tuddenham, Emma Lo, Jessica Lei, Katie Smith, John Sanderson, Barnaby Moran, Carl Collinson, Paul Peacock, Janet Rhodes, Andrew Treacher, David Shock Clinical Aspects 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 noncardiac reasons to the intensive care unit (ICU) in two 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 cutoff ≥15 ng/L and concomitant changes on electrocardiogram, patients were categorized 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: One hundred seventy-two patients were included in the analysis of whom 84% had a cTnT rise ≥15 ng/L. Twenty-one patients (12%) had a definite MI, 51 (30%) had a possible MI, and 73 (42%) had a cTnT rise only. At the 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. Lippincott Williams & Wilkins 2017-06 2017-05-15 /pmc/articles/PMC5419814/ /pubmed/27902530 http://dx.doi.org/10.1097/SHK.0000000000000811 Text en Copyright © 2016 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Shock Society. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Clinical Aspects
Ostermann, Marlies
Ayis, Salma
Tuddenham, Emma
Lo, Jessica
Lei, Katie
Smith, John
Sanderson, Barnaby
Moran, Carl
Collinson, Paul
Peacock, Janet
Rhodes, Andrew
Treacher, David
Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness
title Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness
title_full Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness
title_fullStr Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness
title_full_unstemmed Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness
title_short Cardiac Troponin Release is Associated with Biomarkers of Inflammation and Ventricular Dilatation During Critical Illness
title_sort cardiac troponin release is associated with biomarkers of inflammation and ventricular dilatation during critical illness
topic Clinical Aspects
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419814/
https://www.ncbi.nlm.nih.gov/pubmed/27902530
http://dx.doi.org/10.1097/SHK.0000000000000811
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