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High‐sensitivity cardiac troponin T predicts mortality after hospitalization for community‐acquired pneumonia
Author(s) -
Vestjens Stefan M.T.,
Spoorenberg Simone M.C.,
Rijkers Ger T.,
Grutters Jan C.,
Ten Berg Jurriën M.,
Noordzij Peter G.,
Van de Garde Ewoudt M.W.,
Bos Willem Jan W.
Publication year - 2017
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12996
Subject(s) - medicine , troponin complex , community acquired pneumonia , pneumonia severity index , pneumonia , troponin , troponin t , area under the curve , cardiology , randomized controlled trial , placebo , myocardial infarction , pathology , alternative medicine
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 .