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. 2011 Jan;37(1):77-85.
doi: 10.1007/s00134-010-2051-x. Epub 2010 Oct 12.

Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome

Helge Røsjø  1 , Marjut Varpula, Tor-Arne Hagve, Sari Karlsson, Esko Ruokonen, Ville Pettilä, Torbjørn Omland; FINNSEPSIS Study Group
Collaborators, Affiliations

Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome

Helge Røsjø et al. Intensive Care Med. 2011 Jan.

Abstract

Purpose: To assess the clinical utility of a recently developed highly sensitive cardiac troponin T (hs-cTnT) assay for providing prognostic information on patients with sepsis.

Methods: cTnT levels were measured by the novel hs-cTnT assay at two time points (inclusion and 72 h thereafter) in a subgroup of patients from the FINNSEPSIS study and associations with clinical outcomes were examined. Results for the hs-cTnT assay were compared to those of the established fourth-generation cTnT assay.

Results: cTnT measured by the fourth-generation and hs-cTnT assay was detectable in 124 (60%) and 207 (100%) patients, respectively, on inclusion in this study. hs-cTnT levels on inclusion correlated with several indices of risk in sepsis, including the simplified acute physiology score (SAPS) II and sequential organ failure assessment (SOFA) scores. The level of hs-cTnT on inclusion was higher in hospital non-survivors (n = 47) than survivors (n = 160) (median 0.054 [Q1-3, 0.022-0.227] versus 0.035 [0.015-0.111] μg/L, P = 0.047), but hs-cTnT level was not an independent predictor of in-hospital mortality. hs-cTnT levels on inclusion were also higher in patients with septic shock during the hospitalization (0.044 [0.024-0.171] versus 0.033 [0.012-0.103] μg/L, P = 0.03), while this was not the case for the fourth-generation cTnT assay or NT-proBNP levels.

Conclusions: Circulating hs-cTnT is present in patients with severe sepsis and septic shock, associates with disease severity and survival, but does not add to SAPS II score for prediction of mortality. hs-cTnT measurement could still have a role in sepsis as an early marker of shock.

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Figures

Fig. 1
Fig. 1
Flow chart for the study
Fig. 2
Fig. 2
hs-cTnT levels on inclusion in this study and 72 h thereafter in patients surviving to hospital discharge and in non-survivors. The horizontal line within the box represents the median level, the boundaries of the box quartiles 1–3, and the whiskers range (maximum value restricted to 1.5× interquartile range from the median). # P < 0.05
Fig. 3
Fig. 3
Prognostic accuracy of in-hospital mortality for SAPS II score alone and in combination with troponin T measurements by either the highly sensitive assay or the established fourth-generation assay
Fig. 4
Fig. 4
hs-cTnT and NT-proBNP levels on inclusion in this study in patients with circulatory failure and non-failure during the index hospitalization. The horizontal line within the box represents the median level, the boundaries of the box quartiles 1–3, and the whiskers range (maximum value restricted to 1.5× interquartile range from the median). # P < 0.05
See this image and copyright information in PMC

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