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Int J Cardiol Heart Vasc . Prognostic impact of high sensitive troponin in predicting 30-day mortality among patients admitted to hospital with influenza

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  • Int J Cardiol Heart Vasc . Prognostic impact of high sensitive troponin in predicting 30-day mortality among patients admitted to hospital with influenza


    Int J Cardiol Heart Vasc


    . 2020 Dec 13;32:100682.
    doi: 10.1016/j.ijcha.2020.100682. eCollection 2021 Feb.
    Prognostic impact of high sensitive troponin in predicting 30-day mortality among patients admitted to hospital with influenza


    Yogesh Sharma 1 2 , Chris Horwood 3 , Angela Chua 4 , Paul Hakendorf 3 , Campbell Thompson 5



    AffiliationsFree PMC article

    Abstract

    Background: Worldwide, seasonal influenza causes significant mortality and severe infections may cause cardiac injury. High-sensitive-troponins (hsTnT) are sensitive and specific markers of myocardial damage. This study investigated the prognostic impact of hsTnT on 30-day mortality in hospitalised influenza patients.
    Methods: This retrospective study included influenza patients ≥ 18 years, who had hsTnT performed during admission in two tertiary-hospitals in South Australia. Diagnosis of influenza was confirmed by polymerase-chain-reaction (PCR) test and hsTnT > 14 ng/L with a change of > 20% during admission was considered to be indicative of acute-cardiac injury. Clinical characteristics, complications and 30-day mortality were compared among four groups of patients: hsTnT unavailable, hsTnT negative, chronically elevated hsTnT and acutely elevated hsTnT. Cox-proportional hazard regression determined the hazard of death at 30-days following hospital discharge after adjustment for co-variates.
    Results: Between January 2016 -March 2020, 1828 influenza patients, mean age 66.4 years, were hospitalised. Troponin results were available for 617 (47.7%) patients, of whom, 62 (10%) had acute myocardial injury and 232 (37.6%) had chronic hsTnT elevation. Both inpatient and 30-day mortality were significantly higher among patients with acute (P < 0.001) and chronic hsTnT (P < 0.001) when compared to other groups. When compared to patients with negative hsTnT, acute but not chronic hsTnT elevation was significantly associated with 30-day mortality after adjustment for various co-variates (HR 8.30, 1.80-17.84, P value = 0.013).
    Conclusions: This is the largest available analysis of cardiac-specific biomarker hsTnT in patients with influenza. An acutely elevated hsTnT was associated with 30-day mortality among hospitalised influenza patients.

    Keywords: Acute cardiac injury; Acute coronary syndrome; High sensitive troponin; Influenza; Mortality.

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