Evaluation of cardiac troponin I as a predictor of death in critically ill cats
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Evaluation of cardiac troponin I as a predictor of death in critically ill cats. / Pelander, Lena; Bach, Maiken B.T.; Ljungvall, Ingrid; Willesen, Jakob L.; Koch, Jörgen; Dreimanis, Kristoffer; Telling, Amalie; Damsgard, Rikke M.; Ohlsson, Åsa; Häggström, Jens; Langhorn, Rebecca.
I: Journal of Veterinary Internal Medicine, Bind 37, Nr. 2, 2023, s. 403-411.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Evaluation of cardiac troponin I as a predictor of death in critically ill cats
AU - Pelander, Lena
AU - Bach, Maiken B.T.
AU - Ljungvall, Ingrid
AU - Willesen, Jakob L.
AU - Koch, Jörgen
AU - Dreimanis, Kristoffer
AU - Telling, Amalie
AU - Damsgard, Rikke M.
AU - Ohlsson, Åsa
AU - Häggström, Jens
AU - Langhorn, Rebecca
N1 - Publisher Copyright: © 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
PY - 2023
Y1 - 2023
N2 - Background: Abnormally high serum cardiac troponin I (cTnI) concentration, reflecting leakage from or necrosis of cardiomyocytes, is a negative prognosticator for death in dogs. Objectives: To investigate in critically ill cats whether serum cTnI concentration is abnormally high, identify conditions associated with abnormally high cTnI concentrations, and evaluate cTnI as an independent prognosticator for death and a potential coprognosticator to the acute patient physiologic and laboratory evaluation (APPLE) score in cats. Animals: One hundred nineteen cats admitted to intensive care units (ICU) and 13 healthy cats at 2 university teaching hospitals. Methods: Prospective study. Clinical examinations were performed, APPLE scores calculated, and serum cTnI and serum amyloid A (SAA) measured within 24 hours after admission. Outcome was defined as death/euthanasia or survival to discharge, 28 and 90 days after ICU-admission. Prognostic capacity of cTnI, APPLE scores and models combining cTnI and scores were evaluated by receiver-operator-characteristic analyses. Results: Median (IQR) serum cTnI concentration was higher in ill (0.63 [0.18-2.65] ng/mL) compared to healthy (0.015 [0.005-0.041] ng/mL) cats (P <.001) and higher in subgroups with structural cardiac disease (2.05 [0.54-16.59] ng/mL; P <.001) or SAA >5 mg/L (0.84 [0.23-2.81] ng/mL; P =.009) than in cats without these characteristics (0.45 [0.12-1.70] and 0.35 [0.015-0.96] ng/mL). The in-hospital case fatality rate was 29%. Neither serum cTnI concentration for all critically ill cats (area-under-the-curve 0.567 [95% CI 0.454-0.680], n = 119) or subgroups (0.625 [0.387-0.863], n = 27; 0.506 [0.360-0.652], n = 86), nor APPLE scores (fast 0.568 [0.453-0.682], full 0.585 [0.470-0.699], n = 100), were significant prognosticators for death. Conclusions and Clinical Importance: Abnormally high serum cTnI concentration was common in critically ill cats. Unlike in dogs, cTnI did not confer prognostic information regarding death.
AB - Background: Abnormally high serum cardiac troponin I (cTnI) concentration, reflecting leakage from or necrosis of cardiomyocytes, is a negative prognosticator for death in dogs. Objectives: To investigate in critically ill cats whether serum cTnI concentration is abnormally high, identify conditions associated with abnormally high cTnI concentrations, and evaluate cTnI as an independent prognosticator for death and a potential coprognosticator to the acute patient physiologic and laboratory evaluation (APPLE) score in cats. Animals: One hundred nineteen cats admitted to intensive care units (ICU) and 13 healthy cats at 2 university teaching hospitals. Methods: Prospective study. Clinical examinations were performed, APPLE scores calculated, and serum cTnI and serum amyloid A (SAA) measured within 24 hours after admission. Outcome was defined as death/euthanasia or survival to discharge, 28 and 90 days after ICU-admission. Prognostic capacity of cTnI, APPLE scores and models combining cTnI and scores were evaluated by receiver-operator-characteristic analyses. Results: Median (IQR) serum cTnI concentration was higher in ill (0.63 [0.18-2.65] ng/mL) compared to healthy (0.015 [0.005-0.041] ng/mL) cats (P <.001) and higher in subgroups with structural cardiac disease (2.05 [0.54-16.59] ng/mL; P <.001) or SAA >5 mg/L (0.84 [0.23-2.81] ng/mL; P =.009) than in cats without these characteristics (0.45 [0.12-1.70] and 0.35 [0.015-0.96] ng/mL). The in-hospital case fatality rate was 29%. Neither serum cTnI concentration for all critically ill cats (area-under-the-curve 0.567 [95% CI 0.454-0.680], n = 119) or subgroups (0.625 [0.387-0.863], n = 27; 0.506 [0.360-0.652], n = 86), nor APPLE scores (fast 0.568 [0.453-0.682], full 0.585 [0.470-0.699], n = 100), were significant prognosticators for death. Conclusions and Clinical Importance: Abnormally high serum cTnI concentration was common in critically ill cats. Unlike in dogs, cTnI did not confer prognostic information regarding death.
KW - cardiovascular dysfunction
KW - feline
KW - intensive care unit
KW - myocardial injury
KW - survival
U2 - 10.1111/jvim.16635
DO - 10.1111/jvim.16635
M3 - Journal article
C2 - 36708236
AN - SCOPUS:85147340865
VL - 37
SP - 403
EP - 411
JO - Journal of Veterinary Internal Medicine
JF - Journal of Veterinary Internal Medicine
SN - 0891-6640
IS - 2
ER -
ID: 337601828