title: The usefulness of serum troponin levels to predict 1-year survival rates in infective endocarditis.
abstract: OBJECTIVE
  Infective endocarditis (IE) is associated with increased mortality and morbidity. In this study, we aimed to evaluate the role of troponin levels in predicting long-term survival in patients with IE.
  
  
  METHODS
  A retrospective analysis of the medical database of Yuksek Ihtisas Education and Research Hospital was performed to reach the patients that received the diagnosis of definite IE according to Duke criteria. Out of 84 definite IE cases, 48 patients (mean age 45.6 ± 17.3, 39.6% female) that had troponin T levels measured upon hospital admission were included. The survival status of the study subjects was assessed during a follow-up period of 1 year.
  
  
  RESULTS
  A total of 20 (41.7%) patients died during the follow-up. Baseline median troponin T levels were significantly higher in fatal cases (0.08 [0.02-0.24] ng/ml vs. 0.02 [0.01-0.04] ng/ml p = 0.003). The optimal troponin T level to detect mortality was 0.05 ng/ml according to receiver operating characteristic curve (area under the curve 0.75, 95% Confidence Interval (CI) [0.61-0.9], p = 0.003) with 70% sensitivity and 79% specificity. Patient with elevated troponin levels were older, were more likely to be male and tended to have enterococcal infection. These patients had also higher creatinine levels and increased systolic pulmonary pressures. In the multivariate Cox regression analysis, renal failure (hazards ratio (HR) 8.23, CI 95% 2.53-26.9, p < 0.0001), heart failure (HR 4.48, CI 95% 1.73-11.61, p = 0.002) and troponin T ≥ 0.05 ng/ml (HR 3.11, CI 95% 1.13-8.56, p = 0.03) were associated with increased mortality rates.
  
  
  CONCLUSIONS
  IE has poor outcome and baseline troponin T levels may predict long-term survival rates in these patients.
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: esragucuk@hotmail.com.
authors.forename: Esra
authors.initials: E
authors.lastname: Gucuk Ipek
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Guray
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Acar
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Habibe
authors.initials: H
authors.lastname: Kafes
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Lale
authors.initials: L
authors.lastname: Dinc Asarcikli
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Gizem
authors.initials: G
authors.lastname: Cabuk
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Demirkan
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Mevlut Serdar
authors.initials: MS
authors.lastname: Kuyumcu
authors.affiliation: Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Guray
mesh_terms: D000328:Adult; D000368:Aged; D004696:Endocarditis / Q000097:blood* / Q000401:mortality*; D005260:Female; D006333:Heart Failure / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T
keywords: Infective endocarditis; biomarker; outcome; troponin