Key result
Elevated troponins in sepsis often occur without CAD, signaling myocardial dysfunction and worse prognosis.
Elevated cardiac troponins in sepsis and SIRS often indicate underlying myocardial dysfunction and worse prognosis rather than acute coronary syndrome, suggesting invasive CAD testing may not be routinely needed in the absence of typical ischemic symptoms.
Supports cautious troponin interpretation in sepsis to avoid over-testing for CAD; hypothesis-generating for its role as myocardial dysfunction biomarker.
Elevation of cardiac troponins and creatinine kinase is frequently observed in setting of systemic inflammatory response syndrome (SIRS), sepsis, or septic shock. Underlying pathophysiologic mechanism for such troponin leak, its clinical significance, and what different could be done in such settings remain elusive. In this paper we have briefly overviewed the proposed pathogenic mechanisms for SIRS, sepsis, or septic shock-related troponin elevation (SRTE) and have provided brief overview on its clinical significance. Upon review of the relevant literature we found that majority of patients with the SRTE with no prior history of coronary artery disease (CAD) upon testing are found not to have any CADs. We have also briefly discussed the possible pharmacologic agents and potential targets which are important from pathophysiologic and pharmacologic point of view that may alter the outcomes of SRTE-related myocardial depression in near future.
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Nasir Hussain (2013) conducted a review in Systemic Inflammatory Response Syndrome (SIRS), Sepsis, and Septic Shock. Sepsis-related troponin elevation (SRTE) was evaluated. Elevated cardiac troponins in SIRS, sepsis, or septic shock frequently occur without underlying coronary artery disease and may serve as a biomarker for myocardial dysfunction and worse prognosis.
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