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

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• 作者：Mahmoud Q. Moammar ; Muhammad I. Ali ; Nader A. Mahmood ; Vincent A. DeBari ; M. Anees Khan
• 关键词：Troponin I ; Alveolar-arterial oxygen gradient ; Community-acquired pneumonia ; Myocardial stress ; Biomarkers
• 刊名：Heart, Lung and Circulation
• 出版年：2010
• 出版时间：February 2010
• 年：2010
• 卷：19
• 期：2
• 页码：90-92
• 全文大小：185 K

文摘

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 (r_s = 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.