Document Detail


Elevation of troponin I in sepsis and septic shock.
MedLine Citation:
PMID:  11497154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To detect myocardial damage in severe systemic inflammation by cTnI measurements in patients without acute coronary syndromes. DESIGN: Prospective case control study. SETTING: Tertiary referral center. PARTICIPANTS: Twenty patients with sepsis, septic shock, and systemic inflammatory response syndrome (SIRS) were examined and compared to controls without coronary artery disease or myocarditis. MEASUREMENTS AND RESULTS: cTnI levels were assessed in patients with SIRS, sepsis, and septic shock. Eight patients (two female/six male) suffered from septic shock, nine (three female/six male) from sepsis without shock, and three (three male) from SIRS. Seventeen patients (85%) showed elevated cTnI (median 0.57 microg/l; 0.17-15.4), whereas no patient in the control group showed elevated cTnI (P < 0.0001). Six patients (30%),--three with septic shock and three with sepsis--died during hospitalization, five of them with elevated cTnI. Four out of five autopsies showed normal coronary arteries. Coronary angiography, autopsy, and stress echocardiography ruled out significant coronary artery disease in ten cTnI-positive patients (59%). In 41 % of cTnI-positive patients, Streptococcus pneumoniae could be cultured, whereas no cTnI-negative or control patient showed signs of infection due to S. pneumoniae. CONCLUSION: Cardiac troponin I was elevated in 85% of patients with sepsis, septic shock or SIRS in our study. A high percentage showed infection caused by S. pneumoniae. In what way microorganisms cause cTnI elevations is not yet understood.
Authors:
P Ammann; T Fehr; E I Minder; C Günter; O Bertel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  27     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-08-10     Completed Date:  2001-12-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  965-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Zurich, Switzerland. pammann@swissonline.ch
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiomyopathies / blood*,  etiology
Case-Control Studies
Coronary Vessels / ultrasonography
Female
Humans
Male
Middle Aged
Prospective Studies
Shock, Septic / blood*,  complications
Streptococcus pneumoniae / isolation & purification
Systemic Inflammatory Response Syndrome / blood*,  complications
Troponin I / blood*
Chemical
Reg. No./Substance:
0/Troponin I
Comments/Corrections
Comment In:
Intensive Care Med. 2001 Jun;27(6):959-61   [PMID:  11497152 ]
Intensive Care Med. 2002 Feb;28(2):218; author reply 219   [PMID:  11907669 ]

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