May 6, 2023Open Access
First Sampled High-Sensitive Cardiac Troponin T is Associated With One-Year Mortality in Sepsis Patients and 30- to 365-Day Mortality in Sepsis Survivors
Key Result
Elevated first sampled hs-cTnT in sepsis patients was independently associated with higher 1-year mortality, with the highest quartile having an HR of 5.7 (95% CI, 2.1-16) compared to normal levels.
Study Design
Type
Cohort (n=586)
Multicenter
No
Structured PICO
Does elevated first sampled hs-cTnT predict 30-day and 1-year mortality in sepsis patients requiring vasopressor support?
P
Population
586 sepsis patients requiring vasopressor support, followed for 1 year.
E
Exposure
Elevated first sampled high-sensitive cardiac troponin T (hs-cTnT) levels (≥15 ng/L, divided into quartiles)
C
Comparator
Normal hs-cTnT levels (<15 ng/L)
O
Outcome
30-day and 1-year mortality in sepsis patients, and 30- to 365-day mortality in sepsis survivorshard clinical
First sampled hs-cTnT in critically ill sepsis patients is independently associated with short- and long-term mortality, including in acute phase survivors.
Main Result
Hazard Ratio: 5.7 (95% CI 2.1–16)
Abstract
BackgroundPrevious studies using cardiac troponin levels to investigate the relationship between myocardial injury and mortality in sepsis patients have been conflicting. Our aim was to investigate the relationship between plasma high-sensitive cardiac troponin T (hs-cTnT) level and 30-day and 1-year mortality in sepsis patients and 30- to 365-day mortality in sepsis survivors.MethodsSepsis patients requiring vasopressor support and admitted to our institution between 2012 and 2021 (n = 586) were included in this retrospective cohort study. Elevated hs-cTnT values (≥15 ng/L) were divided into quartiles (Q): Q1 15-35 ng/L; Q2 36-61 ng/L; Q3 62-125 ng/L; Q4 126-8630 ng/L. Stratified Kaplan-Meier curves and multivariable Cox regression were used for survival analyses.ResultsFirst sampled hs-cTnT was elevated in 529 (90%) patients. One-year mortality was 45% (n = 264). Increasing level of hs-cTnT was independently associated with higher adjusted hazard ratios (HR) for 1-year mortality compared with normal levels: Q1 HR 2.9 (95% confidence interval CI, 1.03-8.1); Q2 HR 3.5 (95% CI, 1.2-9.8); Q3 HR 4.8 (95% CI, 1.7-13.4); Q4 HR 5.7 (95% CI, 2.1-16). In acute phase survivors, first sampled hs-cTnT was an independent predictor of 30- to 365-day mortality (HR 1.3; 95% CI, 1.1-1.6 per loge hs-cTnT).ConclusionsFirst sampled plasma hs-cTnT in critically ill sepsis patients was independently associated with 30-day and 1-year mortality. Importantly, first sampled hs-cTnT was associated with mortality during the convalescence phase (30- to 365-day) and could be a feasible marker to identify acute phase survivors at high risk of death.
Cite This Study
Lörstad et al. (Sat,) conducted a cohort in Sepsis (n=586). Elevated high-sensitive cardiac troponin T (hs-cTnT) vs. Normal levels was evaluated on 1-year mortality (HR 5.7, 95% CI 2.1-16). Elevated first sampled hs-cTnT in sepsis patients was independently associated with higher 1-year mortality, with the highest quartile having an HR of 5.7 (95% CI, 2.1-16) compared to normal levels.