Cardiac troponin I levels and alveolar-arterial oxygen gradient in patients with community-acquired pneumonia

Heart, Lung & Circulation
Mahmoud Q MoammarM Anees Khan

Abstract

Patients with community-acquired pneumonia (CAP) appear to have cardiac stress as demonstrated by elevated B-type natriuretic peptide (BNP). We hypothesised that myocardial stress and decrease in oxygenation might also lead to elevations of cardiac troponin I (cTnI) levels in serum. The aim of this study was to see if cTnI was associated with the alveolar-arterial oxygen gradient (DeltaA-a), a marker of severity in CAP. Retrospective cohort study of 901 CAP patients with no evidence of acute coronary syndrome presenting to a large, tertiary-care, urban teaching hospital over a 3-year period. A strong linear trend between log(10)cTnI and DeltaA-a was observed (r(2)=0.76) with a statistically significant Spearman correlation coefficient (r(s)=0.75; p<0.0001) between cTnI and DeltaA-a. A cTnI value of 0.5 ng/ml discriminated mild CAP from moderate-severe CAP with an OR=208 (95% CI: 50.5-408; p<0.0001). These data suggest that decreased blood O(2) levels as suggested by elevated DeltaA-a may lead to acute myocardial damage and that cTnI may be useful as a biomarker to stratify risk in subjects with CAP.

Citations

Aug 10, 2010·American Journal of Respiratory and Critical Care Medicine·Grant W WatererRichard G Wunderink
Jan 30, 2014·American Journal of Veterinary Research·Brandon C FraserDerek A Mosier
Jan 22, 2013·Lancet·Vicente F Corrales-MedinaJulio A Chirinos
Dec 7, 2018·Annals of the American Thoracic Society·Jos F FrenckenUNKNOWN Members of the MARS Consortium
Jun 5, 2015·Journal of Veterinary Emergency and Critical Care·Katherine F SmithLouisa J Rahilly
Feb 23, 2020·Journal of Clinical Medicine·Raúl MéndezRosario Menéndez

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