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 log10 cTnI 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 0.5 ng/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
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Article info
Publication history
Accepted:
August 27,
2009
Received in revised form:
August 25,
2009
Received:
July 8,
2009
Identification
Copyright
© 2009 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
