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Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and

Helge Røsjø1, Marjut Varpula, Tor-Arne Hagve

  • 1Division of Medicine, Akershus University Hospital, Sykehusveien 27, 1478 Lørenskog, Norway.

Intensive Care Medicine
|October 13, 2010
PubMed

Insights

A new highly sensitive cardiac troponin T (hs-cTnT) assay detects troponin in all sepsis patients and associates with disease severity. While not independently predicting mortality, hs-cTnT may serve as an early marker for septic shock.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Biomarker Discovery

Background:

  • Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
  • Cardiac involvement is common in sepsis, and cardiac troponins are established biomarkers of myocardial injury.
  • A novel highly sensitive cardiac troponin T (hs-cTnT) assay offers improved detection capabilities.

Purpose of the Study:

  • To evaluate the clinical utility of the hs-cTnT assay for prognostic information in sepsis patients.
  • To compare the performance of hs-cTnT with a fourth-generation cTnT assay.

Main Methods:

  • A subgroup of patients from the FINNSEPSIS study were included.
  • Cardiac troponin T levels were measured using the hs-cTnT assay at baseline and 72 hours.
  • Associations between hs-cTnT levels and clinical outcomes, including mortality and septic shock, were analyzed.

Main Results:

  • hs-cTnT was detectable in 100% of patients at inclusion, compared to 60% for the fourth-generation assay.
  • hs-cTnT levels correlated with sepsis severity scores (SAPS II, SOFA).
  • Higher hs-cTnT levels were observed in non-survivors and patients with septic shock, but it was not an independent predictor of mortality.

Conclusions:

  • Circulating hs-cTnT is present in severe sepsis and septic shock, correlating with disease severity and survival.
  • hs-cTnT does not improve mortality prediction beyond the SAPS II score.
  • hs-cTnT may serve as an early indicator of septic shock in sepsis patients.
Abstract

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