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Abstract

It is not unusual for high sensitivity cardiac troponin (cTnT) to be measured when a patient presents to hospital with chest symptoms. Often the result can be slightly raised despite the primary problem not being cardiac. It seems logical that a severe pneumonia may cause a troponin leak by causing strain on the heart. This study by Vestjens et al (http://dx.doi.org/10.1111/resp.12996) sought to see if elevated troponin is a prognostic marker in patients admitted with community-acquired pneumonia (CAP).The study looked at cTnT levels on admission in 295 patients admitted with CAP. Levels were elevated (>14 ng/L) in 45%. Short-term (30 days) and long-term (up to 4.1 years) mortality were significantly higher in those with elevated cTnT. Elevated cTNT >28 ng/L was found to be a strong independent risk factor for mortality both short-term (OR 21.9, 95% CI 4.7 to 101.4) and long-term (OR 10.7, 95% CI 5.0 to 22.8). The study also combined troponin levels with the Pneumonia Severity Index (PSI) and found this was a stronger predictor of short-term mortality than PSI score alone. …