The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever

Abstract

Introduction: The incidence of myocarditis on Dengue Hemorrhagic Fever (DHF) is still controversial because the disease was asymptomatic and definitive diagnosis only with endocardial biopsy. More specific and sensitive examination to detect the cardiac disorder is cardiac enzyme likes the level of troponin T. Objective: This study aims to evaluate the level of troponin T in patients with dengue shock syndrome (DSS) and dengue hemorrhagic fever without shock. Methods: The research conducted a cross-sectional study at Child Health Department of Dr. Wahidin Sudirohusodo Hospital, Makassar, from July to October 2012. The population included children with DHF admitted to the hospital of Dr. Wahidin Sudirohusodo, Ibnu Sina and Faisal Islamic. Diagnosis of DHF was established based on history taking, physical and laboratory examination. Results: There were 70 samples who met the criteria, including 35 patients of DSS and 35 patients of dengue hemorrhagic fever without shock. The level of troponin T was higher on DSS group than DHF group with the cut off point of ≥0.007 ng/ml is the best level to distinguish between dengue shock syndrome and dengue hemorrhagic fever without shock (p=0.000, sensitivity 97.1%, specificity 88.6%, positive predictive value 89.5%, negative predictive value 96.9%,OR 18.7; 95% CI 15.3–1417.5). Conclusion: The level of troponin T was higher on DSS group than dengue hemorrhagic fever without shock group because on DSS occurs to stress caused by hypoperfusion. But the level of troponin T between two groups within normal limits, not found cardiac disorder such as myocarditis on DHF.