Distribution of Highly Sensitive Troponin in the Critically Unwell & Associated Mortality

Study Overview
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Brief Summary
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The current diagnostic criteria for a heart attack require evaluation of a patient's symptoms and ECG but importantly a blood test called troponin. With advancing technology this test has become more sensitive and is now called a high sensitivity troponin. This is a very effective way of rapidly excluding a heart attack if the test is negative. However there are a number of causes of a raised high sensitivity other than a heart attack, particularly critical illness states. In the absence of features of a heart attack an abnormal result therefore suggests that the heart is inflamed or unwell causing the release of high sensitivity troponin. The DIGNITY study will examine the consequences of high sensitivity troponin elevation in patients in intensive care and assess whether it has a role as a biomarker for predicting outcome.

Official Title
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Distribution of Highly Sensitive Troponin in the Critically Unwell & Associated Mortality. The DIGNITY Study

Conditions
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Myocardial Infarction, Myocardial Injury

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (aged 18 years or older) admitted to any of the three intensive care facilities on site (general, cardiac and neurosciences) Biochemistry samples already taken as part of routine clinical care during the ICU stay Exclusion Criteria: Patients aged less than 18 years No biochemistry samples taken within the ICU stay

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intensive care population<br>All patients admitted to any of the three adult intensive care units (general, cardiac & neurosciences) at a large teaching hospital. These patients will have a high sensitivity troponin added onto biochemistry samples requested by the clinical team. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Association between high sensitivity troponin and inpatient mortality on all patients admitted to each of the ICU environments at a large teaching hospital |  | During intensive care admission | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Distribution of high sensitivity troponin results for different admissions to intensive care | Distribution of high sensitivity troponin results in Medical admissions Trauma / emergency surgical admissions Planned surgical admissions Post cardiac surgical patients Neurosurgical patients | During intensive care admission | 
| Association between high sensitivity troponin results and duration of ventilation |  | Within twenty eight days | 
| Association between high sensitivity troponin results and length of intensive care admission |  | Number of days not in intensive care within twenty eight days of original intensive care admission | 
| Association between high sensitivity troponin results and requirement for inotropic support |  | During intensive care admission |