Prognostic significance of elevated troponin in non-cardiac hospitalized patients: A systematic review and meta-analysis

Annals of Medicine

Volumn 46, Issue 8, 2014, Pages 653-663

  Ahmed, Amna N ^a   Blonde, Ken ^a   Hackam, Daniel ^a   Iansavichene, Alla ^a   Mrkobrada, Marko ^a  

^a LONDON HEALTH SCIENCES CENTRE   (Canada)

Author keywords

Biomarkers; Inpatients; Mortality; Prognosis; Troponin

Indexed keywords

TROPONIN; TROPONIN I; TROPONIN T; BIOLOGICAL MARKER;

ADVERSE OUTCOME; CARDIAC PATIENT; COCHRANE LIBRARY; DIAGNOSTIC TEST ACCURACY STUDY; HEART DISEASE; HEART FAILURE; HOSPITAL; HOSPITAL ADMISSION; HUMAN; MEDLINE; META ANALYSIS; MORTALITY; PREVALENCE; PROGNOSIS; PROTEIN BLOOD LEVEL; REVIEW; SYSTEMATIC REVIEW; BLOOD; HOSPITALIZATION; TIME;

BIOLOGICAL MARKERS; HOSPITAL MORTALITY; HOSPITALIZATION; HUMANS; PROGNOSIS; TIME FACTORS; TROPONIN; TROPONIN I; TROPONIN T;

EID: 84919384390     PISSN: 07853890     EISSN: 13652060     Source Type: Journal    
DOI: 10.3109/07853890.2014.959558     Document Type: Review

References (43)

1. Babuin L, Jaffe A S. Troponin: the biomarker of choice for the detection of cardiac injury. CMAJ. 2005; 173: 1191-202.
2. Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. J Am Coll Cardiol. 2007; 50: 2173-95.
3. Kehl DW, Iqbal N, Fard A, Kipper BA, De La Parra Landa A, Maisel AS. Biomarkers in acute myocardial injury. Transl Res. 2012; 159: 252-64.
4. White HD. Pathobiology of troponin elevations: do elevations occur with myocardial ischemia as well as necrosis? J Am Coll Cardiol. 2011; 57: 2406-8.
5. De Lemos J A, Drazner MH, Omland T, Ayers CR, Khera A, Rohatgi A, et al. Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population. JAMA. 2010; 304: 2503-12.
6. Weber M, Bazzino O, Navarro Estrada JL, de Miguel R, Salzberg S, Fuselli JJ, et al. Improved diagnostic and prognostic performance of a new high-sensitive troponin T assay in patients with acute coronary syndrome. Am Heart J. 2011; 162: 81-8.
7. Ohman E, Armstrong PW, Christenson RH, Granger CB, Katus HA, Hamm CW, et al. Cardiac troponin T levels for risk stratification in acute myocardial ischemia. GUSTO II Investigators. N Engl J Med. 1996; 335: 1333-41.
8. Hasaan AK, Bergheanu SC, Hasan-Ali H, Liem SS, van der Laarse A, Wolterbeek R, et al. Usefulness of peak troponin-T to predict infarct size and long-term outcome in patients with first acute myocardial infarction after primary percutaneous coronary intervention. Am J Cardiol. 2009; 103: 779-84.
9. DerSimonian R, Liard N. Meta-analysis in clinical trials. C ontrol Clin Trials. 1986; 7: 177-88.
10. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336: 924-6.
11. Afonso L, Bandaru H, Rathod A, Badheka A, Ali Kizibash M, Zmilyy H, et al. Prevalence, determinants, and clinical significance of cardiac troponin-I elevation in individuals admitted for a hypertensive emergency. J Clin Hypertens (Greenwich). 2011; 13: 551-6.
12. Al-Mallah M, Zuberi O, Arida M, Kim H. Positive troponin in diabetic ketoacidosis without evident acute coronary predicts adverse cardiac events. Clin Cardiol. 2008; 31: 67-71.
13. Baillard C, Boussarsar M, Fosse JP, Girou E, Le Toummelin P, Cracco C, et al. Cardiac troponin I in patients with severe exacerbation of chronic obstructive pulmonary disease. Intensive Care Med. 2003; 29: 584-9.
14. Balasubramaniyam N, Aronow W, Lai H, Palaniswamy C, Lorenzo A, Khera S, et al. Prevalence of increased cardiac troponin I levels in hospitalized patients with pneumonia and in-hospital mortality in patients with increased versus normal cardiac troponin I levels. Open Journal of Cardiology. 2012; 3: 1.
15. Bova C, Crocco F, Ricchio R, Serafini O, Greco F, Noto A. Importance of troponin T for the risk stratification of normotensive patients with pulmonary embolism. A prospective, cohort study with a three-month follow-up. Haematologica. 2005; 90: 423-4.
16. Choon-ngram T, Partpisanu P. Serum cardiac troponin-T as a prognostic marker in septic shock. J Med Assoc Th ai. 2008; 91: 1818-21.
17. Fadaii A, S ohrabpour H. Serum troponin levels, APACHE II score and mortality rate for non-cardiac reasons in RCU patients. Tanaffos. 2009; 8: 29-34.
18. Giannitsis E, Muller-Bardorff M, Kurowski V, Weidtmann B, Wiegand U, Kampmann M, et al. Independent prognostic value of cardiac troponin T in patients with confirmed pulmonary embolism. Circulation. 2000; 102: 211-17.
19. Hajsadeghi S, Gholami S, Gohardehi G, Moghadam NS, Sabet AS, Kerman SRJ, et al. Association between troponin T and ICU mortality, a changing trend. Cardiovasc J Afr. 2012; 23: 186-90.
20. Hioseth AD, Neukamm A, Karlsson BD, Omland T, Brekke PH, Soyseth V. Elevated high-sensitivity cardiac troponin T is associated with increased mortality after acute exacerbation of chronic obstructive pulmonary disease. Th orax. 2011; 66: 775-81.
21. Janata KM, Leitner JM, Holzer-Richling N, Janata A, Laggner AN, Jilma B. Troponin T predicts in-hospital mortality in patients with pulmonary embolism. Eur Respir J. 2009; 34: 1357-63.
22. Jimenez D, Diaz G, Molina J. Marti D, Del Rey J, Garcia-Rull S, et al. Troponin I and risk stratification of patients with acute nonmassive pulmonary embolism. Eur Respir J. 2008; 31: 847-53.
23. John J, Woodward DB, Wang Y, Yan AB, Fischer D, Kinasewitz GT, et al. Troponin-I as a prognosticator of mortality in severe sepsis patients. J Crit Care. 2010; 25: 270-5.
24. Kalla C, Raveh D, Algur N, Rudensky B, Yinnon AM. Incidence and significance of a positive troponin test in bacteremic patients without acute coronary syndrome. Am J Med. 2008; 121: 909-15.
25. Kelly AM, Kim S. Is elevated troponin associated with in-hospital mortality in emergency department patients admitted with chronic obstructive pulmonary disease? Eur J Emerg Med. 2013; 20: 54-7.
26. Kim HJ, Ham HS, Cho YJ, Kim HC, Lee JD. Usefulness of cardiac troponin I as a prognostic marker in non-cardiac critically ill patients. Tuberculosis and Respiratory Diseases. 2005; 59: 53-61. [In Korean].
27. King DA, Codish S, Novack V, Barski L, Almog Y. The role of cardiac troponin I as a prognosticator in critically ill medical patients: a prospective observational cohort study. Crit Care. 2005; 9: 390-5.
28. Lankeit M, Jimenez D, Kostrubiec M, Dellas C, Hasenfuss G, Pruszcyk P, et al. Predictive value of the high-sensitivity troponin T assay and the simplified pulmonary severity index in hemodynamically stable patients with acute pulmonary embolism: a prospective validation study. Circulation. 2011; 124: 2716-24.
29. Minkin R, Cotiga D, Noack S, Dobrescu A, Homel P, Shapiro JM. Use of admission troponin in critically ill medical patients. J Intensive Care Med. 2005; 20: 334-8.
30. Ng A, Chow V, Yong A, Chung T, Kritharides L. Elevated troponin T predicts both short and long-term mortality after pulmonary embolism. Heart, Lung and Circulation. 2010; 19S: S216.
31. Palmieri V, Gallotta G, Rendina D, De Bonis S, Russo V, Postiglione A, et al. Troponin I and right ventricular dysfunction for risk assessment in patients with nonmassive pulmonary embolism in the emergency department in combination with clinically based risk score. Intern Emerg Med. 2008; 3: 131-8.
32. Stein R, Gupta B, Agarwal S, Golub J, Bhutani D, Rosman A, et al. Prognostic implications of normal (< 0.10ng/ml) and borderline (0.10 to 1.49ng/ml) troponin elevation levels in critically ill patients without acute coronary syndrome. Am J Cardiol. 2008; 102: 509-12.
33. Tiruvoipati R, Sultana N, Lewis D. Cardiac troponin I does not independently predict mortality in critically ill patients with severe sepsis. Emerg Med Australas. 2012; 24: 151-8.
34. Vasile VC, Babuin L, Rio Perez JA, Alegria JR, Wong Kee Song LM, Chai HS, et al. Long-term prognostic significance of elevated cardiac troponin levels in critically ill patients with acute gastrointestinal bleeding. Crit Care Med. 2009; 37: 140-7.
35. Vasile VC, Chai HS, Khambatta S, Afessa B, Jaffe AS. Significance of elevated cardiac troponin T levels in critically ill patients with acute respiratory disease. Am J Med. 2010; 123: 1049-58.
36. Ver Elst KM, Spapen HD, Nguyen DC, Garbar C, Huyghens LP, Gorus FK. Cardiac troponins I and T are biological markers of left ventricular dysfunction in septic shock. Clin Chem. 2000; 46: 650-7.
37. Wu TT, Yuan A, Chen CY, Chen WJ, Luh KT, Kuo SH, et al. Cardiac troponin I levels are a risk factor for mortality and multiple organ failure in non-cardiac critically ill patients and have an additive effect to the APACHE II score in outcome prediction. Shock. 2004; 22: 95-101.
38. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD. Th ird universal definition of myocardial infarction. J Am Coll Cardiol. 2012; 60: 1581-98.
39. Keller T, Zeller T, Peetz D, Tzikas S, Roth A, Czyz E, et al. Sensitive troponin I assay in early diagnosis of acute myocardial infarction. N Engl J Med. 2009; 361: 868-77.
40. Reichlin T, Hochholzer W, Bassetti S, Steuer S, Stelzig C, Hartwiger S, et al. Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med. 2009; 361: 858-67.
41. Mills NL, Churchhouse AM, Lee KK, Anand A, Gamble D, Shah AS, et al. Implementation of a sensitive troponin I assay and risk of recurrent myocardial infarction and death in patients with suspected acute coronary syndrome. JAMA. 2011; 305: 1201-6.
42. Daniels LB. Making sense of high sensitivity assays and their role in clinical care. Curr Cardiol Rep. 2014; 16: 471.
43. Newby LK, Jesse RL, Babb JD, Christenson RH, De Fer TM, Diamond GA, et al. ACCF 2012 expert consensus document on practical clinical consideration in the interpretation of troponin elevations: a report of the American College of Cardiology Foundation task force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2012; 60: 2427-63.