Cardiac biomarkers in acute burn injury: a systematic review of diagnostic and prognostic utility

OBJECTIVE: Cardiac biomarkers offer potential for early diagnosis and prognosis; however, their utility in burn care is not well established. This systematic review aimed to evaluate the current evidence regarding the diagnostic and prognostic values of cardiac biomarkers in patients with acute burn injuries. METHODS: A systematic search of PubMed and Google Scholar (July 2015-September 2025) was conducted according to the PRISMA guidelines. We included prospective and retrospective observational studies that evaluated troponin (I or T), B-type natriuretic peptide (BNP), or N-terminal pro-BNP (NT-proBNP) in patients with acute burns and reported clinical outcomes. Case reports, reviews, and studies of patients with pre-existing cardiovascular diseases were excluded. RESULTS: Seven original studies were included in this systematic review. The findings consistently demonstrated that elevated troponin levels were associated with larger burn sizes, sepsis, and increased mortality, reflecting systemic stress rather than primary ischemic events. BNP and NT-proBNP levels are strong independent predictors of mortality, sepsis, and toxic myocarditis. Notably, BNP demonstrated superior sensitivity to troponin for the early detection of myocarditis in patients with moderate-to-severe burns. CONCLUSIONS: Cardiac biomarkers are valuable prognostic indicators in acute burn injuries, strongly associated with mortality and major complications. The integration of these factors into clinical practice could significantly enhance early risk stratification.