title: Relation of troponin elevation to outcome in patients with infective endocarditis.
abstract: Elevated troponin is increasingly recognized as a marker of cardiac injury and poor outcomes in diverse disease states. It was hypothesized that patients with infective endocarditis (IE) and elevated cardiac troponin would have more extensive IE and worse clinical outcomes. Patients were enrolled as part of the International Collaboration on Endocarditis (ICE) prospective cohort study; analysis of these patients was done retrospectively. Data from 83 consecutively enrolled patients from a single center were evaluated. Cardiac troponin I (cTnI) was drawn for clinical indications and before any cardiac surgery in 51 of the 83 patients. Outcomes evaluated were hospital mortality, annular or myocardial abscess on the basis of echocardiography or surgery, and central nervous system events. Of 51 patients with cTnI drawn, 33 (65%) had elevated cTnI > or =0.1 mg/dl. There were no differences in age, gender, prosthetic valve IE, Staphylococcus aureus IE, or history of coronary artery disease, congestive heart failure, or diabetes mellitus between patients with and without cTnI elevations. Patients with elevated cTnI were less likely to have isolated right-sided IE and more likely to have left ventricular systolic dysfunction or renal dysfunction (p <0.05 for each). In conclusion, elevated cTnI was associated with the composite of death, abscess, and central nervous system events (p <0.001).
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Purcell
authors.forename: Mahesh
authors.initials: M
authors.lastname: Patel
authors.forename: Amit
authors.initials: A
authors.lastname: Khera
authors.forename: James A
authors.initials: JA
authors.lastname: de Lemos
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Forbess
authors.forename: Sharon
authors.initials: S
authors.lastname: Baker
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Cabell
authors.forename: Gail E
authors.initials: GE
authors.lastname: Peterson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D019210:Troponin I / Q000097:blood*; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D019210:Troponin I