Key result
Elevated troponin in critically ill patients without ACS is linked to higher mortality.
Why the study?
What is the clinical significance of elevated cardiac troponin levels in critically ill patients?
What is the clinical significance of elevated cardiac troponin levels in critically ill patients?
Elevated troponin in critically ill patients indicates myocardial injury and higher mortality risk, but does not necessarily equate to acute myocardial infarction requiring standard ACS treatment.
Answers are grounded in this paper and cite their sources.
Elevated troponin signals myocardial injury and mortality risk in non-ACS critical illness without implying ACS; leaves open optimal management for prospective trials.
PURPOSE OF THE REVIEW: Elevated levels of cardiac troponins, indicative of the presence of cardiac injury, have been reported in critically ill patients. In this review, the incidence, significance, and clinical relevance of elevated troponin levels among this group of patients will be discussed. RECENT FINDINGS: It has been shown that elevated cardiac troponin levels can be present among critically ill septic patients without evidence of myocardial ischemia. Recent studies show that elevated troponin levels are also present in a diverse group of critically ill patients without sepsis or septic shock. In addition, several but not all studies show that the mortality rate of troponin-positive patients is significantly higher compared with troponin-negative patients. SUMMARY: Elevated troponin levels are not only present in patients suffering from acute coronary syndromes but can also be present in critically ill patients. Even minor elevations are specific for myocardial injury. However, every elevated troponin level in the critically ill patient should not be rigorously diagnosed or treated as a myocardial infarction.
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Gunnewiek et al. (2004) conducted a review in Critically ill patients. Elevated cardiac troponin levels vs. Normal troponin levels was evaluated on Mortality rate. Elevated cardiac troponin levels in critically ill patients without acute coronary syndromes indicate myocardial injury and are associated with higher mortality rates in several studies.
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