Detecting myocardial infarction in critical illness using screening troponin measurements and ECG recordings

Lim, Wendy; Holinski, Paula; Devereaux, PJ; Tkaczyk, Andrea; McDonald, Ellen; Clarke, France; Qushmaq, Ismael; Terrenato, Irene; Schunemann, Holger; Crowther, Mark; Cook, Deborah

doi:10.1186/cc6815

Critical Care

Table 1 Clinical characteristics of enrolled patients

From: Detecting myocardial infarction in critical illness using screening troponin measurements and ECG recordings

	Total	MI	Elevated cTn only	No cTn elevation	p value³	p value⁴
	(N = 103)	(N = 37)	(N = 15)	(N = 51)
Age, mean (SD)	64.1 ± 17.5	69.9 ± 14.9	64.3 ± 21.8	59.7 ± 16.9	0.018	- MI vs cTn, p = 0.467 - cTn vs no cTn elevation, p = 0.309 - MI vs no cTn elevation, p = 0.004
Female sex, N (%)	44 (42.7)	16 (43.2)	4 (26.7)	24 (47.1)	0.372	- MI vs cTn, p = 0.352 - cTn vs no cTn elevation, p = 0.236 - MI vs no cTn elevation, p = 0.829
APACHE II score, mean (SD)	21.4 ± 10.3	28.2 ± 9.5	22 ± 8.3	16.2 ± 8.3	<0.0001	- MI vs cTn, p = 0.045 - cTn vs no cTn elevation, p = 0.014 - MI vs no cTn elevation p < 0.0001
Medical, N (%)	65 (63)	32 (86.5)	10 (66.7)	23 (45.1)	<0.0001	- MI vs cTn, p = 0.129 - cTn vs no cTn Elevation p = 0.240 - MI vs no cTn elevation p < 0.0001
Past medical history, N (%)
Smoking	28 (27.2)	10 (27.0)	4 (26.7)	14 (27.5)	0.998	- MI vs cTn, p = 1.000 - cTn vs no cTn elevation, p = 1.000 - MI vs no cTn elevation, p = 1.000
Hypertension	54 (52.4)	24 (64.9)	9 (60.0)	21 (41.2)	0.073	- MI vs cTn, p = 0.760 - cTn vs no cTn elevation, p = 0.245 - MI vs no cTn elevation, p = 0.033
Diabetes mellitus¹	25 (24.3)	13 (35.1)	4 (26.7)	8 (15.7)	0.107	- MI vs cTn, p = 0.747 - cTn vs no cTn elevation, p = 0.446 - MI vs no cTn elevation, p = 0.044
Hyperlipidemia	17 (16.5)	6 (16.2)	5 (33.3)	6 (11.8)	0.141	- MI vs cTn, p = 0.260 - cTn vs no cTn elevation, p = 0.107 - MI vs no cTn elevation, p = 0.549
Documented coronary disease/angina	3 (2.9)	1 (2.7)	1 (6.7)	1 (2.0)	0.632	- MI vs cTn, p = 0.498 - cTn vs no cTn elevation, p = 0.406 - MI vs no cTn elevation, p = 1.000
Prior myocardial infarction	5 (4.9)	4 (10.8)	1 (6.7)	0 (0)	0.062	- MI vs cTn, p = 1.000 - cTn vs no cTn elevation, p = 0.227 - MI vs no cTn elevation, p = 0.028
Congestive heart failure	16 (15.5)	10 (27)	2 (13.3)	4 (7.8)	0.048	- MI vs cTn, p = 0.470 - cTn vs no cTn elevation, p = 0.612 - MI vs no cTn elevation, p = 0.020
Peripheral vascular disease	13 (12.6)	7 (18.9)	3 (20.0)	3 (5.9)	0.124	- MI vs cTn, p = 1.000 - cTn vs no cTn elevation, p = 0.125 - MI vs no cTn elevation, p = 0.088
Stroke/transient ischemic attack	10 (9.7)	5 (13.5)	3 (20.0)	2 (3.9)	0.112	- MI vs cTn, p = 0.676 - cTn vs no cTn elevation, p = 0.073 - MI vs no cTn elevation, p = 0.126
Baseline life support interventions, N (%)
Ventilation
Invasive mechanical ventilation	59 (57.3)	27 (73.0)	7 (46.7)	25 (49.0)	0.054	- MI vs cTn, p = 0.108 - cTn vs no cTn elevation, p = 0.100 - MI vs no cTn elevation, p = 0.029
Non-invasive mechanical ventilation	4 (3.9)	1 (2.7)	1 (6.7)	2 (3.9)	0.799	- MI vs cTn, p = 0.498 - cTn vs no cTn elevation, p = 0.545 - MI vs no cTn elevation, p = 1.000
Inotropes and vasopressors, N (%)
Epinephrine	3 (2.9)	3 (8.1)	0 (0)	0 (0)	0.064	- MI vs cTn, p = 0.548 - cTn vs no cTn elevation, p = NE - MI vs no cTn elevation, p = 0.071
Dopamine²	6 (5.8)	5 (13.5)	0 (0)	1 (2.0)	0.043	- MI vs cTn, p = 0.305 - cTn vs no cTn elevation, p = 1.000 - MI vs no cTn elevation, p = 0.079
Norepinephrine	14 (13.6)	9 (24.3)	2 (13.3)	3 (5.9)	0.045	- MI vs cTn, p = 0.477 - cTn vs no cTn elevation, p = 0.318 - MI vs no cTn elevation, p = 0.024
Dobutamine	2 (1.9)	2 (5.4)	0 (0)	0 (0)	0.162	- MI vs cTn, p = 1.000 - cTn vs no cTn elevation, p = NE - MI vs no cTn elevation, p = 0.174
Phenylephrine	3 (2.9)	3 (8.1)	0 (0)	0 (0)	0.064	- MI vs cTn, p = 0.548 - cTn vs no cTn elevation, p = NE - MI vs no cTn elevation, p = 0.071
Vasopressin	1 (1.0)	1 (2.7)	0 (0)	0 (0)	0.406	- MI vs cTn, p = 1.000 - cTn vs no cTn elevation, p = NE - MI vs no cTn elevation, p = 0.420
Hemodialysis, N (%)
Intermittent dialysis	9 (8.7)	6 (16.2)	1 (6.7)	2 (3.9)	0.125	- MI vs cTn, p = 0.658 - cTn vs no cTn elevation, p = 0.545 - MI vs no cTn elevation, p = 0.065
Continuous renal replacement therapy	1 (1.0)	1 (2.7)	0 (0)	0 (0)	0.406	- MI vs cTn, p = 1.000 - cTn vs no cTn elevation, p = NE - MI vs no cTn elevation, p = 0.420

APACHE = Acute Physiology and Chronic Health Evaluation; cTn = cardiac troponin; MI = myocardial infarction; NE = not estimable; ¹Managed with oral agents and/or insulin; ²>3 μg/kg/min; ³p value indicates a 3-way comparison; ⁴p value indicates a 2-way comparison.

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