Project Title

Prevalence of elevated cardiac troponin and mechanisms of cardiac troponin release among patients with non-cardiac illness in plasma and skeletal muscle tissue 

Background

CTns are regulatory proteins located in cardiac muscle cells and elevated values are diagnostic for myocardial infarction. Still, high concentrations are frequent in several non-cardiac conditions. Around 40% of non-cardiac patients admitted to the emergency room presents with elevated cTns. Furthermore, recent studies show elevated cTns in plasma and skeletal muscle biopsies in patients with skeletal muscle disease. 

Aim

We aimed to investigate the prevalence of cTnT in five clinical non-cardiac disease-groups where frequent elevation of cTnT is previous described; Sepsis, rhabdomyolysis, end-stage renal disease (ESRD), stroke, and major non-cardiac surgery (MNCS). 

Methods

The main study is a prospective cross-sectional cohort study including 300 patients admitted to Herlev Hospital over a 2-year period. Patients with Sepsis, rhabdomyolysis, end-stage renal disease (ESRD), stroke, and major non-cardiac surgery (MNCS) will be included for broad range of clinical examinations as well as an ECG and echocardiography. Patients with elevated cardiac troponin will be eligible for muscle biopsies.  

Preliminary results

142 patients have been included: 39 with sepsis, 15 with rhabdomyolysis, 13 with ESRD, 37 with stroke and 38 with MNCS. 23 patients (16%) had signs of cardiac disease confirmed on echocardiographic and/or electrocardiographic examinations. Out of 119 patients without signs of cardiac disease, elevated cTnT was found in 31 (26%) patients, most frequent in sepsis (56%) and least frequent in stroke (20%).