The prognostic significance of troponin elevation in patients with sepsis: A meta-analysis

Objective: To confirm the association between troponin elevation in patients with sepsis and mortality. Background: Cardiac troponins are sensitive and specific biomarkers of myocardial injury; however their prognostic significance in patients with sepsis is still debated. Methods: PubMed and Ovid MEDLINE were searched for original articles using MeSH terms 'Troponin' and 'Sepsis.' Studies reporting on mortality in patients with sepsis, severe sepsis or septic shock who had troponin measured were eligible for inclusion. Meta-analysis was conducted with Review Manager. Results: Seventeen studies, with total sample size of 1857 patients were included. Elevated troponin was found to be significantly associated with mortality (Risk ratio: 1.91; 95% CI: 1.65-2.22; p < 0.05). Conclusions: Troponin elevation in patients with sepsis confers poorer prognosis and is a predictor of mortality. Further studies are needed to see if more aggressive treatment of this subset of patients, or utilizing new therapeutic approaches will improve mortality. (C) 2015 Elsevier Inc. All rights reserved.