Elevation of troponin I in sepsis and septic shock

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Abstract
Objective: To detect myocardial damage in severe systemic inflammation by cTnI measurements in patients without acute coronary syndromes. Design: Prospective case control study. Setting: Tertiary referral center. Participants: Twenty patients with sepsis, septic shock, and systemic inflammatory response syndrome (SIRS) were examined and compared to controls without coronary artery disease or myocarditis. Measurements and results: cTnI levels were assessed in patients with SIRS, sepsis, and septic shock. Eight patients (two female/six male) suffered from septic shock, nine (three female/six male) from sepsis without shock, and three (three male) from SIRS. Seventeen patients (85%) showed elevated cTnI (median 0.57 µg/l; 0.17–15.4), whereas no patient in the control group showed elevated cTnI (P Streptococcus pneumoniae could be cultured, whereas no cTnI-negative or control patient showed signs of infection due to S. pneumoniae. Conclusion: Cardiac troponin I was elevated in 85% of patients with sepsis, septic shock or SIRS in our study. A high percentage showed infection caused by S. pneumoniae. In what way microorganisms cause cTnI elevations is not yet understood.

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