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Abstract

Introduction: Elevated levels of biochemical markers of myocardial necrosis have been associated with worsened outcomes in critically ill patients, but there are few data on focusing patients with severe pneumonia. We investigated elevated cardiac troponin I (cTnI) levels and their relationship with outcomes in patients who hospitalized for severe pneumonia to intensive care unit (ICU). Methods: From February 2011 to February 2013, Patients who admitted to medical ICU with severe pneumonia and availability of cTnI within 24 hours were included at a tertiary care academic medical center. Patients with evidence of ACS were excluded. A cTnI level> 0.034ng/mL was considered positive. Results: 152 patients (community acquired pneumonia (39.5%), health care associated pneumonia (40.8 %), and hospital acquired pneumonia (19.7%)) were included, 48 of whom died (31.6%). 88 patients had detectable cTnI levels (58%) and median cTnI level was 0.049 ng/mL. Patients with increased cTnI levels had higher in-ICU mortality (38.6% vs. 21.9%, p=0.028). The association between increasing cTnI and mortality remained significant after adjustment in a multivariate model (HRadj =1.427, 95% CI 1.032–1.973, p=0.031). Conclusions: Increased cInI level was significant independent predictor of in ICU mortality in hospitalized patients with severe pneumonia and no other cause for an increased cTnI level.