Stefan M T Vestjens1, Simone M C Spoorenberg1, Ger T Rijkers2,3, Jan C Grutters4,5, Jurriën M Ten Berg6, Peter G Noordzij7, Ewoudt M W Van de Garde8,9, Willem Jan W Bos1. 1. Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands. 2. Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands. 3. Science Department, University College Roosevelt, Middelburg, The Netherlands. 4. Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands. 5. Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands. 6. Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. 7. Department of Anaesthesia, Intensive Care and Pain Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands. 8. Division of Pharmacoepidemiology and Clinical Pharmacology, University of Utrecht, Utrecht, The Netherlands. 9. Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands.
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 randomizedplacebo-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.
RCT Entities:
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.
Authors: Luis F Reyes; Marcos I Restrepo; Cecilia A Hinojosa; Nilam J Soni; Antonio Anzueto; Bettina L Babu; Norberto Gonzalez-Juarbe; Alejandro H Rodriguez; Alejandro Jimenez; James D Chalmers; Stefano Aliberti; Oriol Sibila; Vicki T Winter; Jacqueline J Coalson; Luis D Giavedoni; Charles S Dela Cruz; Grant W Waterer; Martin Witzenrath; Norbert Suttorp; Peter H Dube; Carlos J Orihuela Journal: Am J Respir Crit Care Med Date: 2017-09-01 Impact factor: 21.405
Authors: William W Siljan; Jan C Holter; Annika E Michelsen; Ståle H Nymo; Trine Lauritzen; Kjersti Oppen; Einar Husebye; Thor Ueland; Tom E Mollnes; Pål Aukrust; Lars Heggelund Journal: ERJ Open Res Date: 2019-03-11