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Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome.
Intensive Care Med 2011; 37(1):77-85IC

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.

Authors+Show Affiliations

Division of Medicine, Akershus University Hospital, Sykehusveien 27, 1478 Lørenskog, Norway.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20938765

Citation

Røsjø, Helge, et al. "Circulating High Sensitivity Troponin T in Severe Sepsis and Septic Shock: Distribution, Associated Factors, and Relation to Outcome." Intensive Care Medicine, vol. 37, no. 1, 2011, pp. 77-85.
Røsjø H, Varpula M, Hagve TA, et al. Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome. Intensive Care Med. 2011;37(1):77-85.
Røsjø, H., Varpula, M., Hagve, T. A., Karlsson, S., Ruokonen, E., Pettilä, V., & Omland, T. (2011). Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome. Intensive Care Medicine, 37(1), pp. 77-85. doi:10.1007/s00134-010-2051-x.
Røsjø H, et al. Circulating High Sensitivity Troponin T in Severe Sepsis and Septic Shock: Distribution, Associated Factors, and Relation to Outcome. Intensive Care Med. 2011;37(1):77-85. PubMed PMID: 20938765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome. AU - Røsjø,Helge, AU - Varpula,Marjut, AU - Hagve,Tor-Arne, AU - Karlsson,Sari, AU - Ruokonen,Esko, AU - Pettilä,Ville, AU - Omland,Torbjørn, AU - ,, Y1 - 2010/10/12/ PY - 2010/01/27/received PY - 2010/08/03/accepted PY - 2010/10/13/entrez PY - 2010/10/13/pubmed PY - 2011/5/4/medline SP - 77 EP - 85 JF - Intensive care medicine JO - Intensive Care Med VL - 37 IS - 1 N2 - 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. SN - 1432-1238 UR - https://www.unboundmedicine.com/medline/citation/20938765/full_citation L2 - https://dx.doi.org/10.1007/s00134-010-2051-x DB - PRIME DP - Unbound Medicine ER -