Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation

Rebecca Langhorn; V.  Thawley; M. A. Oyama; L. G. King; M. C. Machen; D. J. Trafny; Jakob Willesen; I. Tarnow; Mads Kjelgaard-Hansen

doi:10.1111/jvim.12402

Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation

Rebecca Langhorn, V. Thawley, M. A. Oyama, L. G. King, M. C. Machen, D. J. Trafny, Jakob Willesen, I. Tarnow, Mads Kjelgaard-Hansen

9 Citationer (Scopus)

Abstract

Background: Myocardial injury, detected by cardiac troponin I and T (cTnI and cTnT), has been associated with long-term death in the noncardiac human intensive care unit (ICU). Hypothesis: Presence of myocardial injury predicts 1-year case fatality in critically ill dogs with systemic inflammation. Animals: Thirty-eight dogs with evidence of systemic inflammation and no primary cardiac disease. Methods: Prospective cohort study. In dogs admitted to the ICU with evidence of systemic inflammation, blood samples were obtained at ICU admission for measurement of cTnI and cTnT, and cTnI was measured once daily during ICU hospitalization. Receiver operating characteristic (ROC) curves were used to examine prognostic capacity of admission cTnI, admission cTnT, and peak cTnI concentrations. Results: One-year case fatality rate was 47% (18/38 dogs). Admission cTnI concentrations were (median [range]) 0.48 [0.004-141.50] ng/mL, and peak cTnI concentrations were 1.21 [0.021-141.50] ng/mL. Admission cTnT concentrations were 15 [<13-3744] ng/L. For each marker, non-survivors had significantly higher concentrations than survivors (P = .0082-.038). ROC analyses revealed areas under curves [95% CI] of 0.707 [0.537-0.843] for peak cTnI and 0.739 [0.571-0.867] for admission cTnT, respectively. At the optimal cut-off, concentrations were 1.17 ng/mL (peak cTnI) and 23 ng/L (admission cTnT), sensitivities were 72% and 72%, and specificities were 70% and 80%, respectively. Conclusions and Clinical Importance: While peak cTnI and admission cTnT are significantly related to 1-year case fatality in critically ill dogs with systemic inflammation, low sensitivities and specificities prevent their prediction of long-term outcome in individual patients. Troponins might play a role in identification of dogs at long-term risk of death.

Originalsprog	Engelsk
Tidsskrift	Journal of Veterinary Internal Medicine
Vol/bind	28
Udgave nummer	5
Sider (fra-til)	1492-1497
Antal sider	6
ISSN	0891-6640
DOI	https://doi.org/10.1111/jvim.12402
Status	Udgivet - 1 sep. 2014

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Langhorn, R., Thawley, V., Oyama, M. A., King, L. G., Machen, M. C., Trafny, D. J., Willesen, J., Tarnow, I., & Kjelgaard-Hansen, M. (2014). Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation. Journal of Veterinary Internal Medicine, 28(5), 1492-1497. https://doi.org/10.1111/jvim.12402

Langhorn, R, Thawley, V, Oyama, MA, King, LG, Machen, MC, Trafny, DJ, Willesen, J, Tarnow, I & Kjelgaard-Hansen, M 2014, 'Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation', Journal of Veterinary Internal Medicine, bind 28, nr. 5, s. 1492-1497. https://doi.org/10.1111/jvim.12402

@article{04ef097d881249b891962c7869ba56d2,

title = "Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation",

abstract = "Background: Myocardial injury, detected by cardiac troponin I and T (cTnI and cTnT), has been associated with long-term death in the noncardiac human intensive care unit (ICU). Hypothesis: Presence of myocardial injury predicts 1-year case fatality in critically ill dogs with systemic inflammation. Animals: Thirty-eight dogs with evidence of systemic inflammation and no primary cardiac disease. Methods: Prospective cohort study. In dogs admitted to the ICU with evidence of systemic inflammation, blood samples were obtained at ICU admission for measurement of cTnI and cTnT, and cTnI was measured once daily during ICU hospitalization. Receiver operating characteristic (ROC) curves were used to examine prognostic capacity of admission cTnI, admission cTnT, and peak cTnI concentrations. Results: One-year case fatality rate was 47% (18/38 dogs). Admission cTnI concentrations were (median [range]) 0.48 [0.004-141.50] ng/mL, and peak cTnI concentrations were 1.21 [0.021-141.50] ng/mL. Admission cTnT concentrations were 15 [<13-3744] ng/L. For each marker, non-survivors had significantly higher concentrations than survivors (P = .0082-.038). ROC analyses revealed areas under curves [95% CI] of 0.707 [0.537-0.843] for peak cTnI and 0.739 [0.571-0.867] for admission cTnT, respectively. At the optimal cut-off, concentrations were 1.17 ng/mL (peak cTnI) and 23 ng/L (admission cTnT), sensitivities were 72% and 72%, and specificities were 70% and 80%, respectively. Conclusions and Clinical Importance: While peak cTnI and admission cTnT are significantly related to 1-year case fatality in critically ill dogs with systemic inflammation, low sensitivities and specificities prevent their prediction of long-term outcome in individual patients. Troponins might play a role in identification of dogs at long-term risk of death.",

author = "Rebecca Langhorn and V. Thawley and Oyama, {M. A.} and King, {L. G.} and Machen, {M. C.} and Trafny, {D. J.} and Jakob Willesen and I. Tarnow and Mads Kjelgaard-Hansen",

year = "2014",

month = sep,

day = "1",

doi = "10.1111/jvim.12402",

language = "English",

volume = "28",

pages = "1492--1497",

journal = "Journal of Veterinary Internal Medicine",

issn = "0891-6640",

publisher = "Wiley-Blackwell",

number = "5",

}

TY - JOUR

T1 - Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation

AU - Langhorn, Rebecca

AU - Thawley, V.

AU - Oyama, M. A.

AU - King, L. G.

AU - Machen, M. C.

AU - Trafny, D. J.

AU - Willesen, Jakob

AU - Tarnow, I.

AU - Kjelgaard-Hansen, Mads

PY - 2014/9/1

Y1 - 2014/9/1

N2 - Background: Myocardial injury, detected by cardiac troponin I and T (cTnI and cTnT), has been associated with long-term death in the noncardiac human intensive care unit (ICU). Hypothesis: Presence of myocardial injury predicts 1-year case fatality in critically ill dogs with systemic inflammation. Animals: Thirty-eight dogs with evidence of systemic inflammation and no primary cardiac disease. Methods: Prospective cohort study. In dogs admitted to the ICU with evidence of systemic inflammation, blood samples were obtained at ICU admission for measurement of cTnI and cTnT, and cTnI was measured once daily during ICU hospitalization. Receiver operating characteristic (ROC) curves were used to examine prognostic capacity of admission cTnI, admission cTnT, and peak cTnI concentrations. Results: One-year case fatality rate was 47% (18/38 dogs). Admission cTnI concentrations were (median [range]) 0.48 [0.004-141.50] ng/mL, and peak cTnI concentrations were 1.21 [0.021-141.50] ng/mL. Admission cTnT concentrations were 15 [<13-3744] ng/L. For each marker, non-survivors had significantly higher concentrations than survivors (P = .0082-.038). ROC analyses revealed areas under curves [95% CI] of 0.707 [0.537-0.843] for peak cTnI and 0.739 [0.571-0.867] for admission cTnT, respectively. At the optimal cut-off, concentrations were 1.17 ng/mL (peak cTnI) and 23 ng/L (admission cTnT), sensitivities were 72% and 72%, and specificities were 70% and 80%, respectively. Conclusions and Clinical Importance: While peak cTnI and admission cTnT are significantly related to 1-year case fatality in critically ill dogs with systemic inflammation, low sensitivities and specificities prevent their prediction of long-term outcome in individual patients. Troponins might play a role in identification of dogs at long-term risk of death.

AB - Background: Myocardial injury, detected by cardiac troponin I and T (cTnI and cTnT), has been associated with long-term death in the noncardiac human intensive care unit (ICU). Hypothesis: Presence of myocardial injury predicts 1-year case fatality in critically ill dogs with systemic inflammation. Animals: Thirty-eight dogs with evidence of systemic inflammation and no primary cardiac disease. Methods: Prospective cohort study. In dogs admitted to the ICU with evidence of systemic inflammation, blood samples were obtained at ICU admission for measurement of cTnI and cTnT, and cTnI was measured once daily during ICU hospitalization. Receiver operating characteristic (ROC) curves were used to examine prognostic capacity of admission cTnI, admission cTnT, and peak cTnI concentrations. Results: One-year case fatality rate was 47% (18/38 dogs). Admission cTnI concentrations were (median [range]) 0.48 [0.004-141.50] ng/mL, and peak cTnI concentrations were 1.21 [0.021-141.50] ng/mL. Admission cTnT concentrations were 15 [<13-3744] ng/L. For each marker, non-survivors had significantly higher concentrations than survivors (P = .0082-.038). ROC analyses revealed areas under curves [95% CI] of 0.707 [0.537-0.843] for peak cTnI and 0.739 [0.571-0.867] for admission cTnT, respectively. At the optimal cut-off, concentrations were 1.17 ng/mL (peak cTnI) and 23 ng/L (admission cTnT), sensitivities were 72% and 72%, and specificities were 70% and 80%, respectively. Conclusions and Clinical Importance: While peak cTnI and admission cTnT are significantly related to 1-year case fatality in critically ill dogs with systemic inflammation, low sensitivities and specificities prevent their prediction of long-term outcome in individual patients. Troponins might play a role in identification of dogs at long-term risk of death.

U2 - 10.1111/jvim.12402

DO - 10.1111/jvim.12402

M3 - Journal article

C2 - 25041343

SN - 0891-6640

VL - 28

SP - 1492

EP - 1497

JO - Journal of Veterinary Internal Medicine

JF - Journal of Veterinary Internal Medicine

IS - 5

ER -

Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation

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