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dc.contributor.authorRivara, Matthew B.
dc.contributor.authorBajwa, Ednan Khalid
dc.contributor.authorJanuzzi, James Louis
dc.contributor.authorGong, Michelle Ng
dc.contributor.authorThompson, B. Taylor
dc.contributor.authorChristiani, David C.
dc.date.accessioned2013-03-18T18:40:42Z
dc.date.issued2012
dc.identifier.citationRivara, Matthew B., Ednan K. Bajwa, James L. Januzzi, Michelle N. Gong, B. Taylor Thompson, and David C. Christiani. 2012. Prognostic significance of elevated cardiac troponin-t levels in acute respiratory distress syndrome patients. PLoS ONE 7(7).en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10436279
dc.description.abstractBackground: Elevated levels of biochemical markers of myocardial necrosis have been associated with worsened outcomes in Acute Respiratory Distress Syndrome (ARDS), but there are few prospective data on this relationship. We investigated elevated cardiac troponin T (cTnT) levels and their relationship with outcome in patients with ARDS. Methods A prospective cohort study of patients with ARDS was conducted at a tertiary-care academic medical center. Patients had blood taken within 48 hours of ARDS onset and assayed for cTnT. Patients were followed for the outcomes of 60-day mortality, number of organ failures, and days free of mechanical ventilation. Echocardiographic and electrocardiographic (ECG) data were analyzed for signs of myocardial ischemia, infarction, or other myocardial dysfunction. Results: 177 patients were enrolled, 70 of whom died (40%). 119 patients had detectable cTnT levels (67%). Median cTnT level was 0.03 ng/mL, IQR 0–0.10 ng/mL, and levels were higher among non-survivors (P = .008). Increasing cTnT level was significantly associated with increasing mortality (P = .008). The association between increasing cTnT level and mortality remained significant after adjustment in a multivariate model (HRadj = 1.45, 95% CI 1.17–1.81, P = .001). Elevated cTnT level was also associated with increased number of organ failures (P = .002), decreased number of days free of mechanical ventilation (P = .03), echocardiographic wall motion abnormalities (P = 0.001), and severity of tricuspid regurgitation (P = .04). There was no association between ECG findings of myocardial ischemia or infarction and elevated cTnT. Conclusions: Elevated cTnT levels are common in patients with ARDS, and are associated with worsened clinical outcomes and certain echocardiographic abnormalities. No association was seen between cTnT levels and ECG evidence of coronary ischemia.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0040515en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395687/pdf/en_US
dash.licenseLAA
dc.subjectMedicineen_US
dc.subjectAnatomy and Physiologyen_US
dc.subjectRespiratory Systemen_US
dc.subjectRespiratory Physiologyen_US
dc.subjectCardiovascularen_US
dc.subjectCardiovascular Imagingen_US
dc.subjectClinical Research Designen_US
dc.subjectCohort Studiesen_US
dc.subjectCritical Care and Emergency Medicineen_US
dc.subjectAcute Cardiovascular Problemsen_US
dc.subjectMultiple Organ Failureen_US
dc.subjectRespiratory Failureen_US
dc.subjectSepsisen_US
dc.subjectEpidemiologyen_US
dc.subjectBiomarker Epidemiologyen_US
dc.titlePrognostic Significance of Elevated Cardiac Troponin-T Levels in Acute Respiratory Distress Syndrome Patientsen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorChristiani, David C.
dc.date.available2013-03-18T18:40:42Z
dc.identifier.doi10.1371/journal.pone.0040515*
dash.contributor.affiliatedJanuzzi, James
dash.contributor.affiliatedBajwa, Ednan
dash.contributor.affiliatedThompson, Elizabeth
dash.contributor.affiliatedGong, Michelle Ng
dash.contributor.affiliatedChristiani, David


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