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Association between troponin T and ICU mortality, a changing trend.

Hajsadeghi S, Gholami S, Gohardehi G, Moghadam NS, Sabet AS, Kerman SR, Moradi M, Mollahoseini R - Cardiovasc J Afr (2012)

Bottom Line: The change in cTnT levels was not significantly different between the deceased and discharged patients (p = 0.4).Changes in cTnT levels during ICU stay did not show a significant trend (power: 0.26).Patients whose cTnT levels were increased on the first and seventh days of ICU stay had a worse survival, which could be associated with cardiac events on admission or at specific times during the stay in ICU.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Initially elevated levels of troponin predict adverse outcomes in patients admitted to the intensive care unit (ICU). No research team has investigated the changes in concentration of cardiac troponin T (cTnT) during ICU stay and their association with patient outcome.

Objective: We investigated whether the change in cTnT levels during ICU stay could predict outcomes (death or survival).

Methods: In this cohort study, all patients admitted to the medical ICU (10 beds) from January to July 2008 were enrolled. Troponin levels were evaluated within the first 24 hours of ICU admission and on the fourth, seventh and 10th days after admission.

Results: The study population (135 patients) had a mean age of 60.9 ± 21.5 years. The outcome was significantly different with regard to normal or elevated cTnT concentrations on the first and seventh days of follow up (p = 0.03 and 0.023, respectively). This difference was non-significant for cTnT levels on the fourth and 10th days after admission (p = 0.69 and 0.78, respectively). The change in cTnT levels was not significantly different between the deceased and discharged patients (p = 0.4).

Conclusion: Changes in cTnT levels during ICU stay did not show a significant trend (power: 0.26). Patients whose cTnT levels were increased on the first and seventh days of ICU stay had a worse survival, which could be associated with cardiac events on admission or at specific times during the stay in ICU.

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Patient survival and comparison between patients with high and low cTnT levels on (A) first day of admission (p = 0.027), (B) seventh day of ICU stay (p = 0.012).
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Figure 3: Patient survival and comparison between patients with high and low cTnT levels on (A) first day of admission (p = 0.027), (B) seventh day of ICU stay (p = 0.012).

Mentions: The survival rate of patients on the fourth, seventh and 10th days after admission was 87, 74 and 72% in normal patients, and 83, 61 and 56% in patients with elevated cTnT levels, respectively. The estimated mean survival time of patients with elevated cTnT levels on admission was 16.77 (SE = 3.38) days, and it was significantly lower than the group with normal levels on admission, with a mean survival time of 26.08 (SE = 3.15) days (p = 0.027). This difference was also significant for cTnT concentration on the seventh day after admission [mean survival 31.6 (SE = 3.6) days in patients with normal cTnT levels vs 19.7 (SE = 2.5) days in patients with elevated cTnT levels, p = 0.012] (Fig. 3A, B).


Association between troponin T and ICU mortality, a changing trend.

Hajsadeghi S, Gholami S, Gohardehi G, Moghadam NS, Sabet AS, Kerman SR, Moradi M, Mollahoseini R - Cardiovasc J Afr (2012)

Patient survival and comparison between patients with high and low cTnT levels on (A) first day of admission (p = 0.027), (B) seventh day of ICU stay (p = 0.012).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3721816&req=5

Figure 3: Patient survival and comparison between patients with high and low cTnT levels on (A) first day of admission (p = 0.027), (B) seventh day of ICU stay (p = 0.012).
Mentions: The survival rate of patients on the fourth, seventh and 10th days after admission was 87, 74 and 72% in normal patients, and 83, 61 and 56% in patients with elevated cTnT levels, respectively. The estimated mean survival time of patients with elevated cTnT levels on admission was 16.77 (SE = 3.38) days, and it was significantly lower than the group with normal levels on admission, with a mean survival time of 26.08 (SE = 3.15) days (p = 0.027). This difference was also significant for cTnT concentration on the seventh day after admission [mean survival 31.6 (SE = 3.6) days in patients with normal cTnT levels vs 19.7 (SE = 2.5) days in patients with elevated cTnT levels, p = 0.012] (Fig. 3A, B).

Bottom Line: The change in cTnT levels was not significantly different between the deceased and discharged patients (p = 0.4).Changes in cTnT levels during ICU stay did not show a significant trend (power: 0.26).Patients whose cTnT levels were increased on the first and seventh days of ICU stay had a worse survival, which could be associated with cardiac events on admission or at specific times during the stay in ICU.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Initially elevated levels of troponin predict adverse outcomes in patients admitted to the intensive care unit (ICU). No research team has investigated the changes in concentration of cardiac troponin T (cTnT) during ICU stay and their association with patient outcome.

Objective: We investigated whether the change in cTnT levels during ICU stay could predict outcomes (death or survival).

Methods: In this cohort study, all patients admitted to the medical ICU (10 beds) from January to July 2008 were enrolled. Troponin levels were evaluated within the first 24 hours of ICU admission and on the fourth, seventh and 10th days after admission.

Results: The study population (135 patients) had a mean age of 60.9 ± 21.5 years. The outcome was significantly different with regard to normal or elevated cTnT concentrations on the first and seventh days of follow up (p = 0.03 and 0.023, respectively). This difference was non-significant for cTnT levels on the fourth and 10th days after admission (p = 0.69 and 0.78, respectively). The change in cTnT levels was not significantly different between the deceased and discharged patients (p = 0.4).

Conclusion: Changes in cTnT levels during ICU stay did not show a significant trend (power: 0.26). Patients whose cTnT levels were increased on the first and seventh days of ICU stay had a worse survival, which could be associated with cardiac events on admission or at specific times during the stay in ICU.

Show MeSH
Related in: MedlinePlus