Patients with infective endocarditis and increased cardiac troponin I levels have a higher incidence of in-hospital mortality and valve replacement than those with normal cardiac troponin I levels.

To investigate the association of increased cardiac troponin I levels with in-hospital mortality and valve replacement in patients with infective endocarditis (IE). The 62 patients included 36 men and 26 women, with a mean age of 60 +/- 9 years, with IE diagnosed by the Duke criteria. All 62 patients had blood drawn for measurement of cardiac troponin I levels. A cardiac troponin I level >0.4 ng/ml was considered increased. All 62 patients underwent transesophageal echocardiography. Student's t tests were used to analyze continuous variables. chi(2) tests were used to analyze dichotomous variables. Transesophageal echocardiography diagnosed valvular vegetations in 56 of the 62 patients (90%). Cardiac troponin I levels were increased in 35 of the 62 patients (57%). In-hospital mortality or valve replacement occurred in 18 of 35 patients (51%) with increased cardiac troponin I levels versus 4 of 27 patients (15%) with normal cardiac troponin I levels (p < 0.005). Patients with IE and increased cardiac troponin I levels have a higher incidence of in-hospital mortality or valve replacement than those with normal cardiac troponin I levels.