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Cardiac troponin elevations among critically ill patients
Jacqueline M T Klein Gunnewiek1, Johannes G Van Der Hoeven
1Department of Clinical Chemistry, University Medical Centre Nijmegen, The Netherlands. j.kleingunnewiek@akc.umcn.nl
Current Opinion in Critical Care
|September 24, 2004
Summary
Elevated cardiac troponin levels in critically ill patients may not always indicate a heart attack. These findings are crucial for understanding cardiac injury in critical illness and improving patient outcomes.
Area of Science:
- Cardiology
- Critical Care Medicine
- Biomarkers
Background:
- Elevated cardiac troponins signal cardiac injury and are observed in critically ill patients.
- The presence and significance of these elevations in critical care settings require further elucidation.
Purpose of the Study:
- To review the incidence, significance, and clinical relevance of elevated troponin levels in critically ill patients.
- To differentiate troponin elevations due to myocardial ischemia from other causes in critical illness.
Main Methods:
- Literature review of studies reporting troponin levels in critically ill populations.
- Analysis of data concerning sepsis, septic shock, and non-ischemic causes of troponin elevation.
Main Results:
- Elevated cardiac troponin levels occur in critically ill patients, including those with sepsis and without sepsis or septic shock.
- Studies suggest a higher mortality rate in troponin-positive critically ill patients compared to troponin-negative patients, though findings are not universal.
Conclusions:
- Elevated troponin levels in critically ill patients are not exclusive to acute coronary syndromes and indicate myocardial injury, even at minor elevations.
- It is crucial to avoid automatically diagnosing or treating all elevated troponin levels in critically ill patients as myocardial infarction.