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Respirology. 2017 Jul;22(5):1000-1006. doi: 10.1111/resp.12996. Epub 2017 Feb 21.

High-sensitivity cardiac troponin T predicts mortality after hospitalization for community-acquired pneumonia.

Author information

1
Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
2
Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands.
3
Science Department, University College Roosevelt, Middelburg, The Netherlands.
4
Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands.
5
Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands.
6
Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
7
Department of Anaesthesia, Intensive Care and Pain Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
8
Division of Pharmacoepidemiology and Clinical Pharmacology, University of Utrecht, Utrecht, The Netherlands.
9
Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands.

Abstract

BACKGROUND AND OBJECTIVE:

Mortality after hospitalization with community-acquired pneumonia (CAP) is high, compared with age-matched controls. Available evidence suggests a strong link with cardiovascular disease. Our aim was to explore the prognostic value of high-sensitivity cardiac troponin T (cTnT) for mortality in patients hospitalized with CAP.

METHODS:

CTnT level on admission was measured (assay conducted in 2015) in 295 patients hospitalized with CAP who participated in a randomized placebo-controlled double-blind trial on adjunctive dexamethasone treatment. Outcome measures were short- (30-day) and long-term (4.1-year) mortalities.

RESULTS:

CTnT levels were elevated (≥14 ng/L) in 132 patients (45%). Pneumonia severity index (PSI) class was 4-5 in 137 patients (46%). Short- and long-term mortality were significantly higher in patients with elevated cTnT levels. cTnT level on admission combined with PSI classification was significantly better in predicting short-term mortality (area under the operating curve (AUC) = 0.903; 95% CI = 0.847-0.960), compared with PSI classification alone (AUC = 0.818; 95% CI = 0.717-0.919). An optimal cTnT cut-off level of 28 ng/L was independently associated with both short- and long-term mortality (OR = 21.9; 95% CI = 4.7-101.4 and 10.7; 95% CI = 5.0-22.8, respectively).

CONCLUSION:

Elevated cTnT level on admission is a strong predictor of short- and long-term mortalities in patients hospitalized with CAP.

KEYWORDS:

biomarkers; cardiovascular system; mortality; pneumonia; troponin T

PMID:
28221010
DOI:
10.1111/resp.12996
[Indexed for MEDLINE]

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