Author + information
- Hanumantha Rao Jogu,
- Amit Vasireddy,
- Muhammad I. Ahmad,
- Obiora Maludum,
- Ahmed Feroz,
- Mohammadtokir Mujtaba,
- Aysha Amjad,
- Reham S.M.A. Elfawal,
- Nishit Vaghasia,
- Abhishek Biswas,
- Simanta Dutta and
- Waqas Qureshi
Background: The role of EKG changes among septic patients with elevated troponin (e-Tn) without symptoms is not clear. We hypothesized that ischemic changes on EKG are associated with mortality in septic patients with e-Tn.
Methods: We examined 936 consecutive patients with e-Tn and sepsis on admission. Those with septic shock were excluded. Ischemic changes were grouped into nonspecific T and/or ST changes, T wave inversion (TWI) and/or ST depression (STD) and ST elevation (STE) as per Minnesota ECG criteria. Cox proportional hazard models adjusted for demographics and clinical covariates examined the association of these groups with all – cause mortality.
Results: Among 936 patients, 164 were with ischemic changes on EKG. In those, 87 were with non-specific T and/or ST changes, 64 with TWI and/or STD >1mm, and 15 with STE. The mean peak Tn level was 1.00 ± 0.09 ng/ml. Over a median follow up of 5 years (IQR 1-7 years), 60 (36.6%) versus 296 (38.3%) deaths were reported in the ischemic EKG changes versus without ischemic EKG changes respectively. In adjusted Cox model, only STE was associated with increased risk of mortality (HR 2.17; 95% CI 1.06 – 4.42, p = 0.03). Neither TWI and/or STD >1 mm or non-specific ST/T wave changes were associated with mortality (Table 1).
Conclusions: STE on EKG in septic patients with e-Tn is an independent predictor of mortality but we did not find a significant relationship of other ischemic EKG changes with mortality. This study suggests that EKG can help stratify septic patients with e-Tn.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-346
- 2017 American College of Cardiology Foundation