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

Stefan M T Vestjens, Simone M C Spoorenberg, Ger T. Rijkers, Jan C Grutters, Jurriën M ten Berg, Peter G. Noordzij, Ewoudt M.W. Van de Garde, Willem Jan W Bos, Douwe H. Biesma, Henrik Endeman, Hans Hardeman, Rik Heijligenberg, Sabine C A Meijvis, Hilde H.F. Remmelts, Heleen van Velzen-Blad, Paul G P Voorn, the Ovidius Study Group

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)1000-1006
Number of pages7
JournalRespirology
Volume22
Issue number5
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • biomarkers
  • cardiovascular system
  • mortality
  • pneumonia
  • troponin T

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