title: High-sensitivity cardiac troponin T predicts mortality after hospitalization for community-acquired pneumonia.
abstract: Mortality after hospitalization with community-acquired pneumonia (CAP) is high, compared with age-matched controls. Available evidence suggests a strong link with cardiovascular disease. Our aim was to explore the prognostic value of high-sensitivity cardiac troponin T (cTnT) for mortality in patients hospitalized with CAP.
  
  
  
  CTnT level on admission was measured (assay conducted in 2015) in 295 patients hospitalized with CAP who participated in a randomized placebo-controlled double-blind trial on adjunctive dexamethasone treatment. Outcome measures were short- (30-day) and long-term (4.1-year) mortalities.
  
  
  
  CTnT levels were elevated (≥14 ng/L) in 132 patients (45%). Pneumonia severity index (PSI) class was 4-5 in 137 patients (46%). Short- and long-term mortality were significantly higher in patients with elevated cTnT levels. cTnT level on admission combined with PSI classification was significantly better in predicting short-term mortality (area under the operating curve (AUC) = 0.903; 95% CI = 0.847-0.960), compared with PSI classification alone (AUC = 0.818; 95% CI = 0.717-0.919). An optimal cTnT cut-off level of 28 ng/L was independently associated with both short- and long-term mortality (OR = 21.9; 95% CI = 4.7-101.4 and 10.7; 95% CI = 5.0-22.8, respectively).
  
  
  
  Elevated cTnT level on admission is a strong predictor of short- and long-term mortalities in patients hospitalized with CAP.
authors.affiliation: Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Stefan M T
authors.initials: SMT
authors.lastname: Vestjens
authors.affiliation: Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Simone M C
authors.initials: SMC
authors.lastname: Spoorenberg
authors.affiliation: Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands.|Science Department, University College Roosevelt, Middelburg, The Netherlands.
authors.forename: Ger T
authors.initials: GT
authors.lastname: Rijkers
authors.affiliation: Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands.|Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Grutters
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Jurriën M
authors.initials: JM
authors.lastname: Ten Berg
authors.affiliation: Department of Anaesthesia, Intensive Care and Pain Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Noordzij
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, University of Utrecht, Utrecht, The Netherlands.|Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Ewoudt M W
authors.initials: EMW
authors.lastname: Van de Garde
authors.affiliation: Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Willem Jan W
authors.initials: WJW
authors.lastname: Bos
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D017714:Community-Acquired Infections / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D003907:Dexamethasone / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011014:Pneumonia / Q000097:blood* / Q000188:drug therapy / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D020107:Troponin T; D003907:Dexamethasone
keywords: biomarkers; cardiovascular system; mortality; pneumonia; troponin T