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Hamacher, Lena (2015): Kardiales Troponin I bei Hunden mit systemischem Entzündungssyndrom (SIRS). Dissertation, LMU München: Tierärztliche Fakultät



Abstract: Background: Myocardial injury can be detected by cardiac troponin I (cTnI) concentrations, which appears to be a predictor of short-term death in critically ill patients. It is unknown if the best prognostic indicator of short-term survival is cTnI measurement at admission or at later time points. Hypothesis/Objectives: Measuring cTnI with a high-sensitivity (hs) test at different time points after admission may be a better short-term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS). Animals: Prospective, observational clinical study of 60 dogs with SIRS. Methods: Cardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3 and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28-day mortality were assessed by receiver operating characteristic (ROC) curve analysis. Results: Forty-one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; p = 0.004) and at the peak time point (median, 0.23 ng/mL; p = 0.01) compared to 19 non-survivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve (AUC) to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score. Conclusions: Increased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow-up measurement of cTnI concentration provides no additional prognostic information for short-term mortality.