High-sensitivity cardiac troponin T predicts mortality after hospitalization for community-acquired pneumonia

Background and objectiveMortality after hospitalization with community-acquired pneumonia (CAP) is high, compared with age-matched controls. Available evidence suggests a strong link with cardiovascular disease. Our aim was to explore the prognostic value of high-sensitivity cardiac troponin T (cTnT) for mortality in patients hospitalized with CAP. Methods CTnT level on admission was measured (assay conducted in 2015) in 295 patients hospitalized with CAP who participated in a randomized placebo-controlled double-blind trial on adjunctive dexamethasone treatment. Outcome measures were short- (30-day) and long-term (4.1-year) mortalities. Results CTnT levels were elevated (14ng/L) in 132 patients (45%). Pneumonia severity index (PSI) class was 4-5 in 137 patients (46%). Short- and long-term mortality were significantly higher in patients with elevated cTnT levels. cTnT level on admission combined with PSI classification was significantly better in predicting short-term mortality (area under the operating curve (AUC)=0.903; 95% CI=0.847-0.960), compared with PSI classification alone (AUC=0.818; 95% CI=0.717-0.919). An optimal cTnT cut-off level of 28ng/L was independently associated with both short- and long-term mortality (OR=21.9; 95% CI=4.7-101.4 and 10.7; 95% CI=5.0-22.8, respectively). ConclusionElevated cTnT level on admission is a strong predictor of short- and long-term mortalities in patients hospitalized with CAP. High mortality rates after hospitalization with community-acquired pneumonia (CAP) have been associated with cardiovascular disease. In a well-described cohort, we demonstrated that cardiac troponin T on admission with CAP is a strong independent predictor of short- and long-term mortality, possibly reflecting acute cardiac damage or disease severity.