Cardiovascular systemCardiac troponin elevations among critically ill patientsGunnewiek, Jacqueline M.T. Kleina; van der Hoeven, Johannes GbEditor(s): Boldt, Joachim Author Information Departments of aClinical Chemistry and bIntensive Care Medicine, University Medical Centre Nijmegen, The Netherlands Correspondence to J.M.T. Klein Gunnewiek, UMC Nijmegen, Department of Clinical Chemistry, HP 564, PO Box 9101, 6500 HB Nijmegen, The Netherlands Tel: 31 243617598; fax: 31 243541743; e-mail: [email protected] Current Opinion in Critical Care: October 2004 - Volume 10 - Issue 5 - p 342-346 doi: 10.1097/01.ccx.0000135514.20538.44 Buy Metrics Abstract Purpose of the review Elevated levels of cardiac troponins, indicative of the presence of cardiac injury, have been reported in critically ill patients. In this review, the incidence, significance, and clinical relevance of elevated troponin levels among this group of patients will be discussed. Recent findings It has been shown that elevated cardiac troponin levels can be present among critically ill septic patients without evidence of myocardial ischemia. Recent studies show that elevated troponin levels are also present in a diverse group of critically ill patients without sepsis or septic shock. In addition, several but not all studies show that the mortality rate of troponin-positive patients is significantly higher compared with troponin-negative patients. Summary Elevated troponin levels are not only present in patients suffering from acute coronary syndromes but can also be present in critically ill patients. Even minor elevations are specific for myocardial injury. However, every elevated troponin level in the critically ill patient should not be rigorously diagnosed or treated as a myocardial infarction. © 2004 Lippincott Williams & Wilkins, Inc.