Background: Seasonal influenza is an important cause of morbidity and mortality worldwide and cardiac injuries are dangerous complications of influenza infection. Cardiac troponins are established biomarkers of myocardial damage.
Objective: The aim of the study was to assess high sensitive Troponin-T (hsTnT) serum levels as a surrogate parameter of cardiac involvement in influenza patients.
Methods: Cross-sectional analysis of 264 patients with laboratory-confirmed influenza virus infection. Routine laboratory parameters, hsTNT, and the history of cardiovascular disease were included in the analysis. Assessed prognostic endpoints were inpatient therapy requirement, death < 30 days after hospitalization and acute cardiac events (ACE) defined as myocardial ischemia, heart failure or new arrhythmia requiring therapy.
Results: Eighty-four patients (31.8%) had increased hsTnT at the initial presentation and twenty patients (7.6%) experienced ACE. Patients with ACE had higher hsTnT (p < 0.01) and CRP (p = 0.04) serum levels compared to patients who did not experience ACE. A binary logistic regression model to predict ACE revealed hsTnT (p < 0.01) and CRP (p = 0.01) to significantly influence the odds for ACE. A hsTnT cut-off of 46,4 ng/l was identified as having the best discriminative potential to identify patients with ACE (sensitivity = 0.7, specificity = 0.8).
Conclusion: To date, this is the largest available analysis of the specific cardiac marker hsTnT in patients with influenza. A slight elevation of hsTnT is a common feature of patients with influenza, however increased hsTnT also highlights a higher risk for cardiac complications and fatal outcome.
Keywords: Biomarker; Cardiotropism; High sensitive Troponin-T; Influenza.
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