Usefulness of troponins for the management of critical patient with non-cardiac disease in the Intensive Care Unit.: Narrative Review

Abstract

Cardiac troponins I and T are components of the myocyte contractile apparatus and are expressed almost exclusively in the heart. Even though high troponine values mean myocardial damage, the pathophysiological mechanisms involved are unclear. Troponin elevation is synonym of myocardial injury and it may be secondary to: 1) coronary artery atherosclerosis leading to type 1 myocardial infarction; 2) an imbalance of oxygen supply and demand leading to a type 2 myocardial infarction; and 3) a myocardial injury in the clinical context of cardiac and non-cardiac diseases. Chronic kidney disease, brain injury, sepsis and lung injury are frequent non-cardiac pathologies that occur with myocardial injury. The objective of this narrative review is to present and order the available evidence about the behavior and utility of cardiac troponins in different prevalent clinical entities in the intensive care unit.