The prognostic significance of troponin elevation in patients with sepsis: A meta-analysis

Sheyin, Olusegun; Davies, Oluwaseun; Duan, Wenlan; Pérez, Xavier

doi:10.1016/j.hrtlng.2014.10.002

Cited by 97 publications

(72 citation statements)

References 32 publications

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“…While in some scenarios the identification of a predisposing condition may be clear (i.e., bleeding followed by MI), in others it may be quite difficult to determine whether the MI was a cause or a consequence, such as in patients with tachyarrythmias or heart failure (17). Moreover, differentiating between type 2 MI (i.e., ischemia) and acute myocardial injury (i.e., toxin or other mechanisms) in settings of sepsis or following non-cardiac surgeries can be controversial (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of patients with type 2 myocardial infarction: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial

Guimarães

Leonardi

Huang

et al. 2018

American Heart Journal

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Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of patients with type 2 myocardial infarction: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial

Guimarães

Leonardi

Huang

et al. 2018

American Heart Journal

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“…The prognosis of these patients in the absence of ACS is less certain, and in recent years, there has been increasing interest in quantifying the prognostic value of cTnI in this setting. Examples of this emerging role for cTnI include recent work showing that the cTnI assay is a useful independent predictor of mortality in patients hospitalised with severe pneumonia [3] and sepsis [4], as well as in prognosticating the risk of long-term cardiac outcomes following acute stroke [5]. …”

Section: Introductionmentioning

confidence: 99%

Incidentally Raised Cardiac Troponin I Has a Worse Prognosis in Older Patients Compared to Those with Normal Cardiac Troponin I and Patients with Acute Coronary Syndrome: A Cohort Study

et al. 2016

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Background: Incidentally elevated cardiac troponin I (cTnI) levels are common in acutely unwell older patients. However, little is known about how this impacts on the prognosis of these patients. Objective: We aimed to investigate whether incidentally elevated cTnI levels (group 1) are associated with poorer outcome when compared to age- and sex-matched patients without an elevated cTnI level (group 2), and to patients diagnosed with acute coronary syndrome (group 3). Patients and Methods: This prospective, matched cohort study placed patients ≥75 years old who were admitted to a University teaching hospital into groups 1-3, based on the cTnI levels and underlying diagnosis. Outcomes were compared between the groups using mixed-effects regression models and adjusted for renal function and C-reactive protein. All-cause mortality at discharge, at 1 month and 3 months, alongside the length of hospital stay (LOS), were recorded. Results: In total, 315 patients were included, with 105 patients in each of the 3 groups. The mean age was 84.8 ± 5.5 years, with 41.9% males. All patients were followed up for 3 months. The percent all-cause mortality at discharge and the LOS for groups 1, 2 and 3 were 12.4, 3.8 and 8.6% and 11.2, 8.5 and 7.7 days, respectively. Group 1 had significantly increased mortality at 3 months [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.12-6.96; p = 0.040] and LOS (OR 1.39, 95% CI 1.08-1.79; p = 0.008) compared to group 2 and did not differ significantly when compared to 3-month mortality (OR 2.39, 95% CI 0.91-6.29; p = 0.079) or LOS (OR 1.26, 95% CI 0.96-1.66; p = 0.097) in group 3. Conclusion: There is a significant association between an incidental rise in cTnI level with mortality and LOS in older patients. Further research is required to evaluate whether a more systematic management of these patients would improve the prognosis.

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“…Quando ocorre um dano à célula do miocárdio, a troponina é liberada na circulação e pode ser mensurada por meio de métodos de imunoensaio (Hamacher et al, 2015;Sheyin et al, 2015;Tiruvoipati et al, 2012). No atual estudo, as concentrações séricas da troponina I cardíaca não demonstraram diferença estatística significativa entre o grupo controle e o grupo piometra sepse ou não sepse, diferindo de Pelaner et al (2008), em que houve diferença significativa na concentração da troponina I em cadelas com piometra se comparadas ao grupo controle.…”

Section: Methodsunclassified

“…A troponina I é uma proteína encontrada em fibras musculares esqueléticas e cardíacas responsáveis pela contração muscular (Hamacher et al, 2015;Sheyin et al, 2015;Tiruvoipati et al, 2012). A troponina I cardíaca é encontrada apenas no coração, sendo expressa exclusivamente pelo miocárdio, e está especialmente associada às miofibrilas, embora pequenas quantidades estejam presentes também no citosol (Dunn et al, 2008).…”

Section: Introductionunclassified

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Troponina I como biomarcador de lesão cardíaca em cães com sepse

Pereira

Muzzi

Figueiredo

et al. 2016

Arq. Bras. Med. Vet. Zootec.

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RESUMO Avaliou-se a troponina I como biomarcador de lesão cardíaca na sepse, além de outros parâmetros hematológicos, em cadelas com piometra. Os grupos avaliados não diferiram estatisticamente na avaliação da concentração sérica da troponina I cardíaca. A quantidade total de leucócitos (mm3) e a porcentagem de bastonetes foram significativamente maiores no grupo sepse (23.221,74±16.848,80mm3 e 5,91±10,18%) quando comparado ao grupo não sepse (14.492,86±6.828,26mm3 e 1,93±1,64%) e ao grupo controle (10.320,00±3.999,02mm3 e 1,65±2,05%). Houve diferença significativa nas concentrações séricas da proteína C reativa (mg/dL) no grupo sepse (19,57±41,69md/dL) se comparado ao grupo não sepse (10,29±12,02mg/dL) e ao grupo controle (3,60±3,53mg/dL). Na avaliação da concentração sérica do lactato, houve diferença significativa entre cães com piometra e cães saudáveis, porém não houve diferença significativa entre os grupos sepse e não sepse. Os resultados do presente estudo indicam que a troponina I cardíaca não pôde ser considerada um biomarcador precoce para injúria miocárdica nos casos de cadela com piometra, pois os resultados das mensurações foram semelhantes entre os grupos, o que indica que pode não ter ocorrido lesão dos cardiomiócitos nessa fase. Já a proteína C reativa e o lactato são possíveis marcadores para inflamação sistêmica, uma vez que demonstraram concentrações séricas significativamente maiores em cadelas com piometra.

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The prognostic significance of troponin elevation in patients with sepsis: A meta-analysis

Cited by 97 publications

References 32 publications

Clinical features and outcomes of patients with type 2 myocardial infarction: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial

Clinical features and outcomes of patients with type 2 myocardial infarction: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial

Incidentally Raised Cardiac Troponin I Has a Worse Prognosis in Older Patients Compared to Those with Normal Cardiac Troponin I and Patients with Acute Coronary Syndrome: A Cohort Study

Troponina I como biomarcador de lesão cardíaca em cães com sepse

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