ELEVATED CARDIAC TROPONIN-I PREDICTS IN HOSPITAL MORTALITY AND INTENSIVE CARE UNIT ADMISSION IN PULMONARY EMBOLISM

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 626A
Author(s):  
Boban Mathew ◽  
Lisa Francis ◽  
Francis Augustine
Keyword(s):  
Intensive Care Unit ◽  
Pulmonary Embolism ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Hospital Mortality ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I

scholarly journals Prognostic Value of Initial Elevation in Cardiac Troponin I Level in Critically Ill Patients Without Acute Coronary Syndrome

2015 ◽  
Vol 35 (2) ◽  
pp. e1-e10 ◽  
Author(s):  
Michael Liu ◽  
Merita Shehu ◽  
Edmund Herrold ◽  
Henry Cohen
Keyword(s):  
Intensive Care Unit ◽  
Acute Coronary Syndrome ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Troponin Level ◽  
Coronary Syndrome

BackgroundCardiac troponin I levels are often obtained to help rule out acute coronary syndrome.ObjectiveTo determine if elevation of troponin level within 24 hours for patients without acute coronary syndrome admitted to the intensive care unit provides important prognostic information. METHODS Patients without acute coronary syndrome admitted to the intensive care unit were prospectively divided into 2 groups according to highest serum level of cardiac troponin I within 24 hours of admission (elevated > 0.049 ng/mL; control ≤ 0.049 ng/mL). Hospital mortality, incidence of intubation, and other parameters were compared between the 2 groups.ResultsPatients with elevated troponin level (n = 40) had higher mortality than did control patients (n = 50) (35% vs 12%; P = .01). Compared with control patients, patients with elevated levels were more likely to be intubated (41% vs 17%; P = .02).ConclusionCritically ill patients without acute coronary syndrome with elevated levels of cardiac troponin I at admission had higher mortality and more intubations than did control patients.

Predictors of In-Hospital Mortality in Patients Receiving Thrombolytic Therapy for Pulmonary Embolism

2011 ◽  
Vol 17 (6) ◽  
pp. 656-658 ◽  
Author(s):  
Haroon L. Chughtai ◽  
Muhammad Janjua ◽  
Fadi Matta ◽  
Fadel Jaweesh ◽  
Paul D. Stein
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
Hospital Mortality ◽  
Right Ventricle ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Massive Pulmonary Embolism ◽  
Cardiac Troponin I

Predictors of in-hospital mortality from massive pulmonary embolism (PE) were retrospectively assessed in 78 patients who received thrombolytic therapy. Mortality from PE was 19% (15 of 78). Mortality from PE was higher in those with shock, 36% (12 of 33) versus no shock, 7% (3 of 45; P = .001), 21% (7 of 34) with right ventricle (RV) hypokinesis, and 20% (13 of 64) with RV enlargement. Mortality was 14% (2 of 14) with normal cardiac troponin I (cTnI), 19% (4 of 21) with intermediate cTnI, and 22% (8 of 36) with high cTnI (comparisons between groups nonsignificant [NS]). Trends with combinations of risk factors showed the highest mortality with shock plus high cTnI plus RV hypokinesis (57%) or shock plus high cTnI plus RV enlargement (54%). In conclusion, among the single risk factors, shock was associated with the highest in-hospital mortality from PE and combinations with high cTnI and RV enlargement were associated with higher mortalities.

scholarly journals Troponin, A Predictor of Mortality in Methadone Exposure: An Observational Prospective Study

2021 ◽  
Author(s):  
Mehdi Sheibani ◽  
Akram Alsadat Mirfallah Nassiri ◽  
Amirhossein Abedtash ◽  
Rebecca McDonald ◽  
Nasim Zamani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Methadone Maintenance ◽  
Characteristic Curve ◽  
Public Health Problem ◽  
Global Public Health ◽  
Cutoff Value

Background Methadone poisoning/overdose is a global public health problem. We aimed to determine whether methadone poisoning increased cardiac troponin and whether high‐sensitivity cardiac troponin I (hs‐cTnI) levels predicted the need for intensive care unit admission, intubation, and mortality. Methods and Results This observational, prospective single‐center study was done at Loghman‐Hakim Hospital (Tehran, Iran) from June 2018 until February 2019. Patients aged >14 years admitted with a diagnosis of methadone exposure were included. Patients were excluded if they had coexisting conditions associated with elevated hs‐cTnI levels. An ECG and hs‐cTnI levels were obtained on emergency department presentation. Patients were followed up on their need for intubation, intensive care unit admission, and in‐hospital mortality. Of 245 included patients (186 [75.9%] men; median age, 33 years), most referred to loss of consciousness (210 cases, 89%). Nineteen (7.7%) patients had hs‐cTnI levels of >0.1 ng/mL (positive), and 41 (16.7%) had borderline levels of 0.019 to 0.1 ng/mL. Twenty‐three (9.3%) cases were admitted to the intensive care unit, 21 (8.5%) needed intubation, and 5 (2%) died during hospitalization. An hs‐cTnI cutoff value of 0.019 ng/mL independently predicted mortality. For optimal concomitant sensitivity and specificity, receiver operating characteristic curve analysis was conducted and showed that hs‐cTnI had an independent significant association with mortality, with a cutoff value of 0.0365 ng/mL (odds ratio, 38.1; 95% CI, 2.3–641.9; P <0.001). Conclusions Methadone exposure/toxicity is a newly identified cause of elevated hs‐cTnI. Values >0.019 ng/mL, and particularly >0.0365 ng/mL, of hs‐cTnI predicted mortality in our sample. Future studies should measure troponin levels in methadone maintenance treatment clients to assess the risk of myocardial injury from long‐term exposure.

High Incidence of Myocardial Ischemia during Postpartum Hemorrhage

2004 ◽  
Vol 100 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Peter C. J. Karpati ◽  
Mathias Rossignol ◽  
Marcus Pirot ◽  
Bernard Cholley ◽  
Eric Vicaut ◽  
...  
Keyword(s):  
Intensive Care ◽  
Myocardial Ischemia ◽  
Hemorrhagic Shock ◽  
Postpartum Hemorrhage ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Elevated Serum ◽  
Cardiac Troponin I ◽  
Arterial Blood

Background Postpartum hemorrhage remains a major cause of global maternal morbidity and mortality, even in developed countries, despite the use of intensive care units. This study sought to (1) assess whether myocardial ischemia could be associated with and even aggravate hemorrhagic shock in young parturients admitted for postpartum hemorrhage, and (2) identify the independent risk factors for myocardial ischemia. Methods On their referral to the intensive care unit, a multidisciplinary team managed parturients with severe postpartum hemorrhage. Ventilation, transfusion, catecholamines, surgery, or angiography with uterine embolization were provided as clinically indicated. Plasma cardiac troponin I levels were used as a surrogate marker of acute myocardial injury and electrocardiograms of myocardial ischemia. Results A total of 55 parturients were referred with severe postpartum hemorrhage, all in hemorrhagic shock. Twenty-eight parturients (51%) had elevated serum levels of cardiac troponin I (9.4 microg/l [3.7-26.6 microg/l]), which were associated with electrocardiographic signs of ischemia and deteriorated myocardial contractility and correlated with the severity of hemorrhagic shock. Indeed, multivariate analysis identified low systolic and diastolic arterial blood pressure (&lt; 88 and &lt; 50 mmHg, respectively) and increased heart rate (&gt; 115 beats/min) as independent predictors of myocardial injury. In addition, all patients who were given catecholamines also had elevated cardiac troponin I levels. Conclusions These results suggest that treatment of postpartum hemorrhage-induced hemorrhagic shock should be coupled with concomitant prevention of myocardial ischemia, even in young parturients.

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