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Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave
- Source :
- Critical Care
- Publisher :
- Springer Nature
-
Abstract
- Introduction The prognostic value of cardiac troponin I (cTnI) in patients having a heat-related illness during a heat wave has been poorly documented. Methods In a post hoc analysis, we evaluated 514 patients admitted to emergency departments during the August 2003 heat wave in Paris, having a core temperature >38.5°C and who had analysis of cTnI levels. cTnI was considered as normal, moderately elevated (abnormality threshold to 1.5 ng.mL-1), or severely elevated (>1.5 ng.mL-1). Patients were classified according to our previously described risk score (high, intermediate, and low-risk of death). Results Mean age was 84 ± 12 years, mean body temperature 40.3 ± 1.2°C. cTnI was moderately elevated in 165 (32%) and severely elevated in 97 (19%) patients. One-year survival was significantly decreased in patients with moderate or severe increase in cTnI (24 and 46% vs 58%, all P < 0.05). Using logistic regression, four independent variables were associated with an elevated cTnI: previous coronary artery disease, Glasgow coma scale 120 μmol.L-1, and heart rate >110 bpm. Using Cox regression, only severely elevated cTnI was an independent prognostic factor (hazard ratio 1.93, 95% confidence interval 1.35 to 2.77) when risk score was taken into account. One-year survival was decreased in patients with elevated cTnI only in high risk patients (17 vs 31%, P = 0.04). Conclusions cTnI is frequently elevated in patients with non-exertional heat-related illnesses during a heat wave and is an independent risk factor only in high risk patients where severe increase (>1.5 ng.mL-1) indicates severe myocardial damage.
- Subjects :
- Male
medicine.medical_specialty
Paris
Cardiac troponin
Heat Stroke
Context (language use)
macromolecular substances
Critical Care and Intensive Care Medicine
Risk Assessment
Cohort Studies
Predictive Value of Tests
Internal medicine
Troponin I
Medicine
Humans
In patient
cardiovascular diseases
Hospitals, Teaching
Aged
Aged, 80 and over
Framingham Risk Score
business.industry
Research
Myocardium
Extreme Heat
Heat wave
musculoskeletal system
Survival Analysis
Surgery
Multicenter study
Predictive value of tests
Cardiology
cardiovascular system
Female
business
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 13648535
- Volume :
- 14
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Critical Care
- Accession number :
- edsair.doi.dedup.....f2ed6e53871da37f4be6f361a4a9b819
- Full Text :
- https://doi.org/10.1186/cc9034