The prognostic significance of serum troponin T levels in Crimean–Congo hemorrhagic fever patients

• Published in: Journal of medical virology Vol. 89; no. 3; pp. 408 - 412
• Main Authors: Yilmaz, Hülya, Yilmaz, Gürdal, Kostakoğlu, Uğur, Yaman, Hüseyin, Örem, Asım, Köksal, İftihar
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2017
• Subjects: Adult; Aged; Biomarkers - blood; Bunyaviridae; CCHF; Crimean–Congo hemorrhagic fever; cTn‐T; Diagnostic Tests, Routine - methods; Female; Hemorrhage - diagnosis; Hemorrhage - pathology; Hemorrhagic Fever, Crimean - diagnosis; Hemorrhagic Fever, Crimean - pathology; Humans; Male; Medical prognosis; Middle Aged; Nuclear polyhedrosis virus; Prognosis; Retrospective Studies; Risk factors; ROC Curve; Sensitivity and Specificity; Serum - chemistry; troponin T; Troponin T - blood; Viral infections; Virology; CCHF; troponin T; cTn-T; Crimean-Congo hemorrhagic fever
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.24454

Crimean–Congo Hemorrhagic Fever (CCHF) is a disease transmitted by the Crimean–Congo hemorrhagic fever virus (CCHFV), characterized by severe fever and hemorrhage and with a reported fatality level of 3–30%. Cerebral hemorrhage, gastrointestinal hemorrhage, severe anemia, shock, myocardial infarction, pulmonary edema, and pleural effusion may be seen as causes of death. Cardiac troponin T (cTn‐T) is a biochemical marker with high sensitivity and specificity in myocardial injury. The purpose of this study was to determine the prognostic significance of serum troponin T levels in CCHF patients. Patients hospitalized with a diagnosis of CCHF and whose serum cTn‐T was investigated were examined retrospectively. Patients were divided into two groups on the basis of presence or absence of hemorrhage. Data were subjected to statistical analysis. One hundred thirty‐five CCHF patients and 72 control subjects were included. Hemorrhage was present in 48 (35.6%) patients. Mean serum cTn‐T level was 17.3 ± 28.0 ng/L in the patients with hemorrhage, 9.98 ± 5.97 ng/L in the non‐hemorrhage patients (P = 0.001) and 6.6P = 2.6 ng/L in the control samples (P < 0.001). At a cTn‐T level cut‐off point of 9 ng/L, area under the ROC curve was 0.797 (95%CI: 0.730–0.854), sensitivity 83.0%, specificity 87.5%, PPD 95.7%, and NPV 60.3%. At logistic regression analysis, a rise in cTn‐T level above 14 ng/L increased the probability of hemorrhage in CCHF patients approximately threefold. An increased troponin T level may be a prognostic risk factor for hemorrhage in CCHF patients. This marker should therefore be borne in mind in determining treatment strategy in these patients. J. Med. Virol. 89:408–412, 2017. © 2015 Wiley Periodicals, Inc.