Heart, Lung and Circulation
Volume 19, Issue 2 , Pages 90-92, February 2010

Cardiac Troponin I Levels and Alveolar-arterial Oxygen Gradient in Patients with Community-acquired Pneumonia

  • Mahmoud Q. Moammar, MD

      Affiliations

    • Division of Pulmonary Medicine, Department of Internal Medicine, St. Joseph's Regional Medical Center, Paterson, NJ, United States
    • School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, United States
    • ,
  • Muhammad I. Ali, MD

      Affiliations

    • Division of Pulmonary Medicine, Department of Internal Medicine, St. Joseph's Regional Medical Center, Paterson, NJ, United States
    • ,
  • Nader A. Mahmood, MD

      Affiliations

    • Division of Pulmonary Medicine, Department of Internal Medicine, St. Joseph's Regional Medical Center, Paterson, NJ, United States
    • ,
  • Vincent A. DeBari, PhD

      Affiliations

    • School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, United States
    • Corresponding Author InformationCorresponding author.
    • ,
  • M. Anees Khan, MD

      Affiliations

    • Division of Pulmonary Medicine, Department of Internal Medicine, St. Joseph's Regional Medical Center, Paterson, NJ, United States
    • School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, United States

Received 8 July 2009; received in revised form 25 August 2009; accepted 27 August 2009.

Background

Patients with community-acquired pneumonia (CAP) appear to have cardiac stress as demonstrated by elevated B-type natriuretic peptide (BNP). We hypothesised that myocardial stress and decrease in oxygenation might also lead to elevations of cardiac troponin I (cTnI) levels in serum.

Objective

The aim of this study was to see if cTnI was associated with the alveolar-arterial oxygen gradient (ΔA-a), a marker of severity in CAP.

Methods

Retrospective cohort study of 901 CAP patients with no evidence of acute coronary syndrome presenting to a large, tertiary-care, urban teaching hospital over a 3-year period.

Results

A strong linear trend between log10cTnI and ΔA-a was observed (r2=0.76) with a statistically significant Spearman correlation coefficient (rs=0.75; p<0.0001) between cTnI and ΔA-a. A cTnI value of 0.5ng/ml discriminated mild CAP from moderate-severe CAP with an OR=208 (95% CI: 50.5–408; p<0.0001).

Conclusions

These data suggest that decreased blood O2 levels as suggested by elevated ΔA-a may lead to acute myocardial damage and that cTnI may be useful as a biomarker to stratify risk in subjects with CAP.

Keywords: Troponin I, Alveolar-arterial oxygen gradient, Community-acquired pneumonia, Myocardial stress, Biomarkers

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S1443-9506(09)01057-9

doi:10.1016/j.hlc.2009.08.009

Heart, Lung and Circulation
Volume 19, Issue 2 , Pages 90-92, February 2010

Article Tools

* Image Usage & Resolution