Volume 11 Supplement 2

27th International Symposium on Intensive Care and Emergency Medicine

Open Access

Elevation of Troponin T in critically ill septic patients is common: but does it matter?

  • A Thornley1,
  • A Turley1,
  • M Johnson1,
  • B Kunadian1,
  • M de Belder1 and
  • J Gedney1
Critical Care200711(Suppl 2):P239

https://doi.org/10.1186/cc5399

Published: 22 March 2007

Background

Troponin T (TnT) is an established marker of adverse outcome in acute coronary syndrome patients and aids risk stratification. Myocardial dysfunction and elevated of TnT are common in critically ill patients and cardiology advice is often sought.

Objective

To evaluate the role of TnT as a predictor of all-cause mortality in patients with severe sepsis/septic shock as defined by international criteria.

Methods

A prospective observational study was performed on patients admitted to a general adult ICU within 24 hours of the development of severe sepsis/septic shock. Serial TnT samples were taken over the first 96 hours. Patients were grouped into three groups: A, TnT < 0.01 ng/ml; B, TnT 0.01–0.099 ng/ml; and C, TnT > 0.099 ng/ml.

Results

Blood from 49 patients was analysed. The peak Troponin level was elevated (>0.01 ng/ml) in 39/49 patients (80%). There was no significant difference between the three groups in terms of hypertension, history of angina, myocardial infarction or systolic blood pressure at time of ICU admission. Patients with undetectable TnT levels (<0.01 g/ml) had significantly lower 6-month mortality rates than those with detectable levels (group A 2/10 (20%) vs Group B/C 23/39 (59%), P = 0.037; group B 8/15 (53%), group C 15/24 (63%)). See Table 1.

Table 1

Group

Number

APACHE II score

Mean age (years)

Inotropic support

Mortality

A

10

18.5 (8.2)

52 (17)

8

2/10

B

15

20 (5.7)

63 (15)

15

8/15

C

24

22.2 (6.8)

65 (14)

22

15/24

Conclusion

Elevated biochemical markers of cardiac myocyte damage are common in patients with severe sepsis/septic shock. TnT elevation is a predictor of 6-month all-cause mortality. Clinicians should be aware of the significance of an elevated TnT assay in this patient population.

Authors’ Affiliations

(1)
The James Cook University Hospital

Copyright

© BioMed Central Ltd. 2007

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