Relationship of Troponin I in Septic Patients Without Cardiac Disease

Abstract

Background: Septic shock, marked by high morbidity and mortality, entails multiple organ dysfunction. Troponin I (TnI), linked to cardiac injury, rises in septic patient’s sans prior cardiac disease, hinting at myocardial involvement. Methods: A prospective analysis was conducted on n=280 samples collected from patients hospitalized between March and February of 2023, who presented with clinical suspicion of infection. TnI levels were measured upon admission, and patient demographics, clinical characteristics, and outcomes were recorded. Results: Among the patients, 45% exhibited elevated TnI levels upon ICU admission. Of these, 65% progressed to severe sepsis or septic shock during their hospital stay. Additionally, 30% of patients with elevated TnI levels experienced adverse outcomes, including increased mortality and prolonged hospitalization. The mean TnI level in septic patients without known cardiac disease was 0.78 ng/mL (standard deviation: 0.32 ng/mL). Elevated TnI levels showed a significant association with sepsis severity, as evidenced by higher Sequential Organ Failure Assessment (SOFA) scores (p < 0.05), increased in-hospital mortality (p < 0.01), and longer ICU stays (p < 0.05). Conclusions: Elevated TnI levels in septic patients without cardiac disease suggest myocardial involvement in sepsis. TnI's association with adverse outcomes highlights its potential as a prognostic marker, warranting further research for clinical implications.