Elevated Cardiac Troponin levels indicate mortality risk in influenza patients
Influenza most often causes a self-limited respiratory illness and in some instances, may be severe enough to require hospitalization and may even lead to death. In recent research, published in the journal ICJ Heart & Vasculature, researchers have found elevated levels of troponin is associated with the 30-day mortality among hospitalized influenza patients.
Worldwide, more than 1 million deaths may be associated with an influenza pandemic with some strains of avian influenza having a case fatality rate of as high as 60%. Although influenza poses a significant burden to the health of the global population, there are still gaps in the understanding of the precise magnitude of this burden measured in terms of long-term outcomes, complications and costs, especially in patients with severe infection. The impact of troponin levels in predicting long term clinical outcomes among patients with influenza is unknown. Therefore, a research team of South Australia conducted a study to investigate the prognostic impact of hsTnT on 30-day mortality in hospitalised influenza patients.
It was a multicentric retrospective observational study in 1828 patients ≥ 18 years, who had hsTnT performed during admission in two tertiary-hospitals in South Australia between January 2016 to March 2020. They confirmed the diagnosis of influenza by polymerase-chain-reaction (PCR) test and hsTnT > 14 ng/L with a change of > 20% during admission was considered to be indicative of acute-cardiac injury. Clinical characteristics, complications and 30-day mortality were compared among four groups: hsTnT unavailable, hsTnT negative, chronically elevated hsTnT and acutely elevated hsTnT.
Upon analyzing the troponin results of 617 (47.7%) patients, researchers found that 62 (10%) had an acute myocardial injury and 232 (37.6%) had chronic hsTnT elevation. They also found both inpatient and 30-day mortality were significantly higher among patients with acute and chronic hsTnT when compared to other groups. When compared to patients with negative hsTnT, they noted acute but not chronic hsTnT elevation was significantly associated with 30-day mortality after adjustment for various covariates (HR 8.30)
The authors concluded, "This is the largest available analysis of cardiac-specific biomarker hsTnT in patients with influenza. An acutely elevated hsTnT was associated with 30-day mortality among hospitalised influenza patients".
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