TY - JOUR 
A1 - Postigo, Andrea
AU - Bermejo, Javier
AU - Muñoz, Patricia
AU - Valerio Minero, Maricela
AU - Marín, Mercedes
AU - Pinilla, Blanca
AU - Cuerpo, Gregorio
AU - Marí, Amaia
AU - Fernández Avilés, Francisco
AU - Martínez Sellés Oliveria Soares, Manuel
AU - Et al.
T1 - Troponin elevation is very common in patients with infective endocarditis and is associated with a poor outcome
Y1 - 2020
SN - 0167-5273

UR - http://hdl.handle.net/11268/8829
AB - Introduction
We sought to study the prevalence of cardiac troponin T (TnT) elevation in patients with infective endocarditis (IE) and its association with in-hospital outcomes.

Methods and results
Retrospective single-center study. From 2008 to 2018, 528 patients were diagnosed with IE and 250 (47.3%) had at least a TnT determination during hospital admission, 103 with conventional TnT assay and 147 with high-sensitive assay. Elevated TnT levels were found in 210 patients (84.0%). Compared with patients with normal TnT levels, patients with TnT elevation presented higher in-hospital mortality (5 [12.5%] vs. 77 [36.7%], p < 0.001) and more frequent complications: heart failure (9 [22.5%] vs. 106 [50.5%], p < 0.001), cardiac abscesses (4 [10.0%] vs 58 [27.6%], p = 0.03), conduction disorders (0 vs. 26 [12,4%]; p = 0.04), and involvement of the central nervous system (1 [2.5%] vs. 38 [18.1%];p = 0.02). Patients with elevated TnT had more frequent indication for surgery (24 [60.0%] vs. 179 [85.2%], p < 0.001) and were operated on more frequently (16 [40.0%] vs 123 [58.6%], p = 0.03). TnT elevation was an independent predictor of in-hospital mortality (OR 3.31; 95% CI 1.02–10.72, p = 0.05). Adding TnT data to conventional clinical models improved the predictive capability of in-hospital mortality (R2: 0.407 vs. 0.388, χ2: 85.03 vs. 80.40, p < 0.001), resulting in a net reclassification improvement of 0.29 (95% CI: 0.13–0.46, p < 0.01).

Conclusions
TnT elevation is very common in patients with IE and is associated with increased in-hospital mortality and complications, thus routine monitoring should be recommended.
KW - Cardiología
KW - Enfermedades
KW - Proteínas
KW - Enfermedad cardiovascular
KW - Proteína
LA - spa
ER -