High‐sensitivity cardiac troponin T predicts mortality after hospitalization for community‐acquired pneumonia

ABSTRACT Background and objective Mortality after hospitalization with community‐acquired pneumonia (CAP) is high, compared with age‐matched controls. Available evidence suggests a strong link with cardiovascular disease. Our aim was to explore the prognostic value of high‐sensitivity cardiac troponin T (cTnT) for mortality in patients hospitalized with CAP. Methods CTnT level on admission was measured (assay conducted in 2015) in 295 patients hospitalized with CAP who participated in a randomized placebo‐controlled double‐blind trial on adjunctive dexamethasone treatment. Outcome measures were short‐ (30‐day) and long‐term (4.1‐year) mortalities. Results CTnT levels were elevated (≥14 ng/L) in 132 patients (45%). Pneumonia severity index (PSI) class was 4–5 in 137 patients (46%). Short‐ and long‐term mortality were significantly higher in patients with elevated cTnT levels. cTnT level on admission combined with PSI classification was significantly better in predicting short‐term mortality (area under the operating curve (AUC) = 0.903; 95% CI = 0.847–0.960), compared with PSI classification alone (AUC = 0.818; 95% CI = 0.717–0.919). An optimal cTnT cut‐off level of 28 ng/L was independently associated with both short‐ and long‐term mortality (OR = 21.9; 95% CI = 4.7–101.4 and 10.7; 95% CI = 5.0–22.8, respectively). Conclusion Elevated cTnT level on admission is a strong predictor of short‐ and long‐term mortalities in patients hospitalized with CAP. High mortality rates after hospitalization with community‐acquired pneumonia (CAP) have been associated with cardiovascular disease. In a well‐described cohort, we demonstrated that cardiac troponin T on admission with CAP is a strong independent predictor of short‐ and long‐term mortality, possibly reflecting acute cardiac damage or disease severity. See Editorial, page 845