Correlation of cardiac troponin I levels with infective endocarditis & its adverse clinical outcomes

Background: To study the association of increased cardiac troponin I levels in infective endocarditis (IE) with its adverse clinical outcomes including in-hospital mortality, perivalvular invasive infection and central nervous system events. Methods: A prospective cohort study of 26 patients comprising of 19 males and 7 females with an average age of 28 years diagnosed with IE using Modified Duke Criteria were taken. A blood sample was drawn from each patient and all samples were analyzed for quantitative estimation of troponin I using ELISA technique. A cardiac troponin I level > 1.0 ng/ml was considered increased. All data was analyzed by independent-samples t test using SPSS Version 16.0. Results: All 26 patients had vegetations diagnosed on echocardiography. Of the 26 patients, 9 (35%) had elevated cardiac troponin I levels and 17 patients (65%) had normal cardiac troponin I levels. Of the 9 patients who had elevated cardiac troponin I levels, 7 (77.78%) had adverse clinical outcomes, the level of statistical significance being p value < 0.0002. Of the 17 patients with normal cardiac troponin I levels, only 1 (5.88%) had adverse clinical outcome, the level of statistical significance being p value < 0.0001. Conclusion: Patients with IE and increased cardiac troponin I levels have worse prognosis with increased incidence of adverse clinical outcomes than those with IE and normal cardiac troponin I levels reflecting potential of cardiac troponin I as a prognostic marker in IE. (C) 2016 Elsevier Ireland Ltd. All rights reserved.