Troponin and CKMB Trends in Patients with Septic Shock Randomized to Vasopressin (VP) or Norepinephrine (NE)

Background: Cardiac troponins are sensitive and specific biomarkers of myocardial necrosis. Elevated troponin levels have been reported in patients with septic shock. We compared the effects of VP vs NE infusion on troponin, CK and CKMB in adults with septic shock (VASST, NEJM 2008;358:877). Results: 126 patients, mean age 62A?16, APACHE II 29.2A?7.9, 68% male, had troponin, CK and CKMB measured. 5 patients (1 VP, 4 NE) had a clinical diagnosis of myocardial infarction, based on ECG changes and cardiac biomarkers, over the 4 study days. At the 4 time points, 44, 52, 45, and 33% of patients had elevations in troponin, respectively.