Predictive value of troponin T for short-term outcomes in patients with infective endocarditis

Elevated cardiac troponin T (cTnT) is a reliable biomarker of myocardial injury, but few studies have linked it to infective endocarditis (IE).

To evaluate the prognostic value of cTnT in patients with IE.

Consecutive patients with definite IE who met the inclusion criteria were included and divided into three groups based on the tertiles of cTnT at admission. Univariate and multivariable analyses were used to assess the value of cTnT in predicting the short-term prognosis of patients with IE.

A total of 1095 patients with definite IE were included, 368 with cTnT<12pg/mL, 362 with cTnT 12-42pg/mL and 365 with cTnT>42pg/mL. In-hospital and 6-month mortality were 6.8% and 9.8%, respectively. Patients with higher cTnT levels exhibited higher in-hospital mortality (0.3% vs 6.6% vs 13.7% across increasing cTnT tertiles; P<0.001). Multivariable logistic analysis indicated that log-transformed cTnT constituted an independent predictor of in-hospital mortality (adjusted odds ratio [OR] 2.780, 95% confidence interval [CI] 1.845-4.189; P<0.001). Receiver operating characteristic curve analysis indicated that the optimal cTnT cut-off was 22pg/mL (area under the curve 0.759, 95% CI 0.716-0.803; P<0.001). Kaplan-Meier analysis revealed that patients with cTnT>22pg/mL had a higher 6-month mortality than those with cTnT ≤22pg/mL (log-rank=68.5; P<0.001). In the multivariable Cox model, cTnT>22pg/mL remained an independent predictor of 6-month mortality (adjusted hazard ratio [HR] 5.032, 95% CI 2.745-9.225; P<0.001).

Elevated cTnT is associated with poorer short-term prognosis in patients with IE, suggesting its potential value as a prognostic biomarker for risk stratification in this population.