Review Article

Elevated Cardiac Troponins in Setting of Systemic Inflammatory Response Syndrome, Sepsis, and Septic Shock

Table 1


AuthorsTotal population Troponin positive No CAD in troponin positive (%) patients CAD in troponin positive (%)CAD could not be determined in troponin positive No CAD in troponin positive who underwent testing Total deaths Troponin positive patients deaths/total populationTroponin positive patients deaths/total deathsMost common pathogen found in SRTE

Turner et al. [2]1512 (80%)4 (26.7%)4/15
(26.7%)
4/4 (100%)

Ammann et al. [3]*20 (sepsis, SIRS, or septic shock)
(no prior CAD ever)
17/20 (85%)10/17 (58.8%)1/17 (5.88%)
CAD was found at autopsy
6/17 (35.2%)10/11 (91%) 6 (30%)5/20 (25%) 5/6 (83%)53% gram positive, Streptococcus pneumoniae, 25% gram negative

Altmann et al. [4]*38 (sepsis, SIRS, or septic shock)
(no prior CAD ever)
22/38 (58%) 14/22 (64%) 1/22 CAD found at autopsy (4.54%)7/22 (32%) 14/15 (93.33%)10 (26%)6/38 (15.7%)6/10 (60%)40% gram positive, 29% gram negative, 26% culture −ve, 5% fungal

Ammann et al. [5]*58 (SIRS, sepsis, septic shock, and other diseases, 7 patients)32/58 (55%)
32/51 (62.7%), 7 patients excluded as diagnosis was not SRTE
23/32 (72%)2/32 (6%)7 (22%)23/25 (92%) 16 (28%)13/51 (25.4%)13/16 (81.3%)Gram positive 29.4%, gram negative 37.2%, viral/fungal 0.078%, undetermined cause in remainder

Fernandes et al. [9]10 (no prior CAD) (septic patients)64/10 (40%)3/10 (30%)3/4 (75%)

Ver Elst et al. [10]46 (septic shock patients) (some had prior history of CAD)23 (50%) 21/46 (46%) 9/46 (19.5%) 9/21 (42.8%) Gram negative bacteremia

Mehta et al. [11]37 (sepsis, SIRS, or septic shock)
(no prior CAD ever)
16/37 (43%)15 (41%)10/37 (27%)10/15
(66.66%)

Arlati et al. [12]19 septic shocks, severe sepsis patients11/19 (58%) 10 (septic groups)

Spies et al. [13]2618 (69%)18 (69%)15 (58%)15/18 (83%)

Summary of studies with the SRTE, *studies where some form of cardiac testing, invasive (angiogram) or noninvasive (stress echocardiogram), was done to rule out CAD in patients with no preexisting CAD, data from the autopsy results also included.