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What Raises Troponins in the Paediatric Population?

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Abstract

Troponin I is a cardiac enzyme that is released during myocardial injury. However, cardiac enzymes are non-specific and can occur in many cardiac and non-cardiac pathologies. We aim to (1) describe the range of acute conditions that were associated with raised troponins in the paediatric population in our institution and (2) quantify the extent of troponin elevation and correlate it with the underlying aetiology. We performed a retrospective observational study in a tertiary institution which included patients from 1 January 2009 to 31 December 2013. We identified patients with troponin I levels of more than 0.1 ng/ml who have not had cardiac surgery before. We recorded their final diagnoses, and then compared the peak troponin levels and the eventual final diagnoses. We identified 100 patients. The top few common diagnoses resulting in a raised troponin were sepsis (29%), cardiac pathologies (29%) such as tachyarrhythmias and cardiomyopathies and myocarditis (21%). Other pathologies included trauma and other causes of multiorgan dysfunction. The median peak troponin I was higher in cardiac as compared to non-cardiac pathologies: 2.15 (0.52–15.0) and 0.44 (0.21–1.68), respectively. There was no statistically significant difference in the peak troponin I values in the presence of hypotension or renal impairment. We described the range of conditions that may result in raised troponin I levels. The extent of raised troponin I levels may potentially be useful in differentiating between cardiac and non-cardiac pathologies. However, further studies on a larger scale are required to establish whether extent of troponin I elevation has a diagnostic role for cardiac pathologies.

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Authors and Affiliations

  1. Children’s Emergency, KK Women’s and Children’s Hospital, Singapore, Singapore

    Debbra Chong, Yan Ting Chua, Shu-Ling Chong & Gene Yong-Kwang Ong

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  1. Debbra Chong
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  2. Yan Ting Chua
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  3. Shu-Ling Chong
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  4. Gene Yong-Kwang Ong
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Correspondence to Debbra Chong.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Chong, D., Chua, Y.T., Chong, SL. et al. What Raises Troponins in the Paediatric Population?. Pediatr Cardiol 39, 1530–1534 (2018). https://doi.org/10.1007/s00246-018-1925-5

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  • DOI: https://doi.org/10.1007/s00246-018-1925-5

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