Frequency and the Factors Associated with Increasing troponin in Patients Admitted to the Intensive Care Unit of Alzahra Hospital, Isfahan, Iran, during the Years 2018-2019

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Fellowship of Anesthesiology and Critical Care, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

4 General Practitioner, Iranian Social Security Organization, Isfahan, Iran

Abstract

Background: Some studies have shown that serum levels of troponin increase in some other diseases in addition to heart diseases. The aim of this study was to determine the frequency and factors associated with increasing troponin in patients admitted to the intensive care unit.Methods: In this cross-sectional study, 62 patients admitted to intensive care units (ICU) of Alzahra hospital, Isfahan, Iran, during the Years 2018-2019, were selected. Patients’ serum troponin levels were measured, and based on the outcomes including cardiac, pulmonary, systemic, and renal complications, frequency of mortality, duration of hospitalization in ICU, and duration of intubation were analyzed.Findings: The mean serum level of troponin I was 47.12 ± 4.38 and 50.00 ± 2.59 ng/l in the living and dead patients, respectively (P = 0.033). The mean serum level of troponin T was 0.57 ± 0.05 and 1.07 ± 0.08 ng/l in the living and dead patients, respectively (P < 0.001). Moreover, troponin I level was significantly different based on the age groups, and serum level of troponin T was different based on the causes of admission in ICU.Conclusion: Our study shows that in addition to patients with myocardial infarction (MI), other patients such as the elderly who hospitalized in the ICUs and patients with intracerebral hemorrhage, may also be at increased troponin levels.

Keywords

References

  1. Jaffe AS. Improving the specificity of cardiac biomarkers-the early development of cardiac troponin I (cTnI) Assays. Clin Chem 2018; 64(3): 609-10.
  2. Bose A, Jain V, Kawthekar G, Chhabra C, Hemvani N, Chitnis DS. The importance of serial time point quantitative assessment of cardiac troponin I in the diagnosis of acute myocardial damage. Indian J Crit Care Med 2018; 22(9): 629-31.
  3. Hammarsten O, Mair J, Mockel M, Lindahl B, Jaffe AS. Possible mechanisms behind cardiac troponin elevations. Biomarkers 2018; 23(8): 725-34.
  4. Lim W. JOE DOUPE LECTURE: Cardiac troponin in the intensive care unit. Clin Invest Med 2009; 32(5): E405-E410.
  5. Lim W, Qushmaq I, Cook DJ, Crowther MA, Heels-Ansdell D, Devereaux PJ. Elevated troponin and myocardial infarction in the intensive care unit: A prospective study. Crit Care 2005; 9(6): R636-R644.
  6. Hjort M, Lindahl B, Baron T, Jernberg T, Tornvall P, Eggers KM. Prognosis in relation to high-sensitivity cardiac troponin T levels in patients with myocardial infarction and non-obstructive coronary arteries. Am Heart J 2018; 200: 60-6.
  7. Devereaux PJ. The potential for troponin to inform prognosis in patients with stable coronary artery disease. Ann Intern Med 2018; 169(11): 808-9.
  8. Otsuka K, Nakanishi K, Shimada K, Nakamura H, Inanami H, Nishioka H, et al. Associations of sensitive cardiac troponin-I with left ventricular morphology, function and prognosis in end-stage renal disease patients with preserved ejection fraction. Heart Vessels 2018; 33(11): 1334-42.
  9. Raji H, Valipour A, Moradi M, Dastoorpoor M, Malamir MD, Ghanbaran A. The prognostic value of cardiac troponin I in acute exacerbation phase of chronic obstructive pulmonary disease. Curr Respir Med Rev 2018; 14(3): 161-5.
  10. Korosoglou G, Lehrke S, Mueller D, Hosch W, Kauczor HU, Humpert PM, et al. Determinants of troponin release in patients with stable coronary artery disease: Insights from CT angiography characteristics of atherosclerotic plaque. Heart 2011; 97(10): 823-31.
  11. Babuin L, Jaffe AS. Troponin: the biomarker of choice for the detection of cardiac injury. CMAJ 2005; 173(10): 1191-202.
  12. Favory R, Neviere R. Bench-to-bedside review: Significance and interpretation of elevated troponin in septic patients. Critical care (London, England) 2006; 10(4): 224.
  13. Jeremias A, Gibson CM. Narrative review: alternative causes for elevated cardiac troponin levels when acute coronary syndromes are excluded. Ann Intern Med 2005; 142(9): 786-91.
  14. Ammann P, Maggiorini M, Bertel O, Haenseler E, Joller-Jemelka HI, Oechslin E, et al. Troponin as a risk factor for mortality in critically ill patients without acute coronary syndromes. J Am Coll Cardiol 2003; 41(11): 2004-9.
  15. Quenot JP, Le TG, Quantin C, Doise JM, Abrahamowicz M, Masson D, et al. Myocardial injury in critically ill patients: Relation to increased cardiac troponin I and hospital mortality. Chest 2005; 128(4): 2758-64.
  16. Ikeda J, Zenimoto M, Kita M, Mori M. Usefulness of cardiac troponin I in patients with acute myocardial infarction. Rinsho Byori 2002; 50(10): 982-6. [In Japanese].
  17. Karciauskaite D, Grybauskiene R, Statkeviciene A, Auskalniene R. Comparison of clinical performance of troponin T and troponin I in diagnosing acute myocardial infarction. Medicina (Kaunas) 2004; 40(5): 439-45. [In Lithuanian].
  18. Ebell MH, Flewelling D, Flynn CA. A systematic review of troponin T and I for diagnosing acute myocardial infarction. J Fam Pract 2000; 49(6): 550-6.
  19. Joseph S, Kumar S, Ahamed MZ, Lakshmi S. Cardiac troponin-T as a marker of myocardial dysfunction in term neonates with perinatal asphyxia. Indian J Pediatr 2018; 85(10): 877-84.
  20. Zarich SW, Qamar AU, Werdmann MJ, Lizak LS, McPherson CA, Bernstein LH. Value of a single troponin T at the time of presentation as compared to serial CK-MB determinations in patients with suspected myocardial ischemia. Clin Chim Acta 2002; 326(1-2): 185-92.
  21. Ogawa M, Abe S, Saigo M, Kozono T, Yamaguchi K, Toda H, et al. Usefulness of rapid bedside cardiac troponin T assay for the diagnosis of acute myocardial infarction. J Cardiol 2000; 35(3): 157-64. [In Japanese].
Journal of Isfahan Medical School
Volume 38, Issue 571 - Serial Number 571
March and April 2020
Pages 231-236

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History

  • Receive Date: 10 March 2020
  • Revise Date: 03 May 2024
  • Accept Date: 06 April 2022

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