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.
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.
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.
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).
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.
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Accepted: August 27, 2009
Received in revised form: August 25, 2009
Received: July 8, 2009
© 2009 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.