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

• Published in: Intensive care medicine 2011-01, Vol.37 (1), p.77-85
• Main Authors: Røsjø, Helge, Varpula, Marjut, Hagve, Tor-Arne, Karlsson, Sari, Ruokonen, Esko, Pettilä, Ville, Omland, Torbjørn
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology; Biological and medical sciences; Biomarkers; Cardiovascular disease; Comparative analysis; Coronary vessels; Critical Care Medicine; Emergency and intensive care: infection, septic shock; Emergency Medicine; Female; Finland; Heart failure; Hospital Mortality; Hospitals; Humans; Intensive; Intensive care; Intensive care medicine; Male; Medical prognosis; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Mortality; Original; Pain Medicine; Patient outcomes; Patients; Pediatrics; Physiological aspects; Physiology; Pneumology/Respiratory System; Prospective Studies; Sensitivity and Specificity; Sepsis; Sepsis - blood; Sepsis - mortality; Septic shock; Severity of Illness Index; Shock, Septic - blood; Shock, Septic - mortality; Troponin T - blood; Vein & artery diseases
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-010-2051-x

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.