The Utility of Troponin in Predicting Cardiac Dysfunction in Pediatric Patients: A Meta-Analysis
Rachna Kadakia1, Corneila Muntean1, Lauren R Klein2
1Pediatric Emergency Medicine, Good Samaritan University Hospital, West Islip, USA.
Elevated troponin levels in children with chest pain are linked to myocardial dysfunction. This finding suggests troponin may serve as a prognostic biomarker in pediatric cardiology, aiding risk assessment.
Area of Science:
- Pediatric Cardiology
- Biomarker Discovery
- Cardiovascular Research
Background:
- Troponins are established biomarkers for acute coronary syndrome and mortality risk in adults.
- Limited data exists on troponin's utility for risk stratification in pediatric chest pain cases.
Purpose of the Study:
- To investigate elevated troponin as a prognostic biomarker for myocardial dysfunction in pediatric patients (0-21 years) presenting with chest pain.
Main Methods:
- Systematic review and meta-analysis of English-language studies from PubMed and Cochrane (inception-2023).
- Included studies reported troponin levels and myocardial dysfunction association.
- Assessed methodological quality using the Quality in Prognosis Studies tool.
Main Results:
- Six studies with 3,144 pediatric patients were analyzed.
- Elevated troponin significantly increased the risk of myocardial dysfunction (OR, 3.30; 95% CI, 2.19-4.40).
- High interstudy heterogeneity (I²=87%) was noted, influenced by study design and bias.
Conclusions:
- Elevated troponin is associated with myocardial dysfunction in children experiencing chest pain.
- Further high-quality, multi-site studies are required to guide clinical implementation of troponin testing in pediatric chest pain evaluations.
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