American Journal of Cardiology
Volume 102, Issue 5 , Pages 509-512 , 1 September 2008

Prognostic Implications of Normal (<0.10 ng/ml) and Borderline (0.10 to 1.49 ng/ml) Troponin Elevation Levels in Critically Ill Patients Without Acute Coronary Syndrome

  • Russell Stein, MD

      Affiliations

    • Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R Kravis Center for Cardiovascular Health, Mount Sinai Medical Center, New York
    • Corresponding Author InformationCorresponding author: Tel: 917-407-1715; fax: 212-722-1630
    • ,
  • Bhanu Gupta, MD

      Affiliations

    • Cardiology Section and Medical Service, Bronx Veterans Affairs Medical Center, Bronx, New York
    • ,
  • Sanjay Agarwal, MD

      Affiliations

    • Cardiology Section and Medical Service, Bronx Veterans Affairs Medical Center, Bronx, New York
    • ,
  • Jason Golub, MD

      Affiliations

    • Department of Medicine, Jacobi Medical Center, Bronx, New York
    • ,
  • Divaya Bhutani, MD

      Affiliations

    • Cardiology Section and Medical Service, Bronx Veterans Affairs Medical Center, Bronx, New York
    • ,
  • Alan Rosman, MD

      Affiliations

    • Cardiology Section and Medical Service, Bronx Veterans Affairs Medical Center, Bronx, New York
    • ,
  • Calvin Eng, MD

      Affiliations

    • Cardiology Section and Medical Service, Bronx Veterans Affairs Medical Center, Bronx, New York

Received 6 February 2008 ,Revised 17 April 2008 ,Accepted 17 April 2008.

References 

  1. Morrow DA, Cannon CP, Rifai N, Frey MJ, Vicari R, Lakkis N, et al Ability of minor elevations of troponins I and T to predict benefit from an early invasive strategy in patients with unstable angina and non-ST elevation myocardial infarction: results from a randomized trial. JAMA. 2001;286:2405–2412
  2. Antman EM, Tanasijevic MJ, Thompson B, Schactman M, McCabe CH, Cannon CP, et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med. 1996;335:1342–1349
  3. Roongsritong C, Warraich I, Bradley C. Common causes of troponin elevations in the absence of acute myocardial infarction: incidence and clinical significance. Chest. 2004;125:1877–1884
  4. 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;41:2004–2009
  5. Quenot JP, Le Teuff G, Quantin C, Doise JM, Abrahamowicz M, Masson D, et al. Myocardial injury in critically ill patients: relation to increased cardiac troponin and hospital mortality. Chest. 2005;128:2758–2764
  6. Wu TT, Yuan A, Chen CY, Chen WJ, Luh KT, Kuo SH, et al. Cardiac Troponin I Levels are a risk factor for mortality and have an additive effect to the APACHE II score in outcome prediction. Shock. 2004;22:95–101
  7. King DA, Codish S, Novack V, Barski L, Almog Y. The role of cardiac troponin I as a prognostic factor in critically ill medical patients: a prospective observational cohort study. Crit Care. 2005;9(suppl):R390–R395
  8. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270:2957–2963
  9. Gudmundsson GS, Kahn SE, Moran JF. Association of mild transient elevation of troponin levels with increased mortality and major cardiovascular events in the general patient population. Arch Pathol Lab Med. 2005;129:474–480
  10. Pham MX, Whooly MA, Evans GT, Liu C, Emadi H, Tong W, et al. Prognostic value of low-level cardiac troponin-I elevations in patients without acute coronary syndrome. Am Heart J. 2004;148:776–782
  11. Relos RP, Hasinoff IK, Beilman GJ. Moderately elevated serum troponin concentrations are associated with increased morbidity and mortality rates in surgical intensive care unit patients. Crit Care Med. 2003;31:2598–2603
  12. ver Elst KM, Spapen HD, Nguyen DN, Garbar C, Huyghens LP, Gorus FK. Cardiac troponins I and T are biological markers of left ventricular dysfunction in septic shock. Clin Chem. 2000;46:650–657
  13. Kollef MH, Ladenson JH, Eisenberg PR. Clinically recognized cardiac dysfunction: an independent determinant of mortality among critically ill patients (Is there a role for serial measurement of cardiac troponin I?). Chest. 1997;111:1340–1347

PII: S0002-9149(08)00751-0

doi: 10.1016/j.amjcard.2008.04.026

American Journal of Cardiology
Volume 102, Issue 5 , Pages 509-512 , 1 September 2008

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