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Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
EXPRESS: MYOCARDIAL INJURY IN CATS WITH ACUTE BLUNT TRAUMA: PREVALENCE AND PROGNOSTIC IMPLICATIONS
Greta Dossi1, Marta Mismetti1, Liliana Carnevale1
1Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
Abstract:
ObjectivesTo determine the prevalence of increased serum high-sensitivity cardiac troponin I (hs-cTnI) concentrations in cats with acute blunt trauma and assess associations with trauma severity, clinicopathological variables, echocardiographic findings, and short-term outcome.MethodsThirty-nine cats presenting within 48 hours of blunt trauma were prospectively enrolled. All cats underwent physical examination, Animal Trauma Triage scoring, thoracic radiography, electrocardiography, echocardiography, complete blood count, serum biochemistry, NTproBNP testing, and hs-cTnI measurement. Associations between hs-cTnI concentrations and clinical, laboratory, echocardiographic, and outcome variables were assessed. Receiver operating characteristic (ROC) analysis was performed as an exploratory assessment of prognostic performance.ResultsIncreased hs-cTnI concentrations were detected in 34/39 cats (87%; 95% CI 72-96%). A significant ordinal association was identified between trauma severity and hs-cTnI class (linear-by-linear association, p=0.036), although the overall Fisher-Freeman-Halton test was not significant (p=0.088). Hs-cTnI concentrations correlated positively with urea, creatinine, neutrophil count, ALT, NLR, blood glucose, IVSd, and LVPWd, and negatively with LVIDd. Increased left ventricular wall thickness was identified in 10/39 cats and was associated with higher hs-cTnI concentrations (p=0.033). No traumatic cardiac rupture, pericardial effusion, or pleural effusion were observed. Electrocardiographic abnormalities were detected in 6/39 cats and were not associated with hs-cTnI concentrations. Seven cats (18%) died during hospitalization. Increased urea concentration , white blood cell count, and neutrophil count were associated with non-survival. ROC analyses were considered exploratory because of the limited number of outcome events.Conclusions and relevanceIncreased hs-cTnI concentrations were common in cats with acute blunt trauma and were associated with leukocyte variables, renal function markers, and subtle echocardiographic abnormalities. These findings suggest that hs-cTnI may reflect a multifactorial biological response involving myocardial stress or injury, systemic disease severity, altered renal handling, and possible underlying subclinical cardiac disease. Further studies are needed to clarify the relative contribution and clinical significance of these mechanisms.
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