Incidence and Clinical Impact of Myocardial Injury Following Traumatic Brain Injury: A Pilot TRACK-TBI Study.

Journal Article (Journal Article)

BACKGROUND: Traumatic brain injury (TBI) is a major global health problem. Little research has addressed extracranial organ dysfunction following TBI, particularly myocardial injury. Using a sensitive marker of myocardial injury-high sensitivity troponin (hsTn)-we examined the incidence of early myocardial injury following TBI and explored its association with neurological outcomes following moderate-severe TBI. METHODS: We conducted a pilot cohort study of 133 adult (age above 17 y) subjects enrolled in the TRACK-TBI 18-center prospective cohort study. Descriptive statistics were used to examine the incidence of myocardial injury (defined as hsTn >99th percentile for a standardized reference population) across TBI severities, and to explore the association of myocardial injury with a 6-month extended Glasgow Outcome Score among patients with moderate-severe TBI. RESULTS: The mean (SD) age of the participants was 44 (17) years, and 87 (65%) were male. Twenty-six patients (20%) developed myocardial injury following TBI; myocardial injury was present in 15% of mild TBI patients and 29% of moderate-severe TBI patients (P=0.13). Median (interquartile range) hsTn values were 3.8 ng/L (2.1, 9.0), 5.8 ng/L (4.5, 34.6), and 10.2 ng/L (3.0, 34.0) in mild, moderate, and severe TBI participants, respectively (P=0.04). Overall, 11% of participants with moderate-severe TBI and myocardial injury experienced a good outcome (6-mo extended Glasgow Outcome Score≥5) at 6 months, compared with 65% in the group that did not experience myocardial injury (P=0.01). CONCLUSIONS: Myocardial injury is common following TBI, with a likely dose-response relationship with TBI severity. Early myocardial injury was associated with poor 6-month clinical outcomes following moderate-severe TBI.

Full Text

Duke Authors

Cited Authors

  • Krishnamoorthy, V; Manley, GT; Jain, S; Sun, S; Foreman, B; Komisarow, J; Laskowitz, DT; Mathew, JP; Hernandez, A; James, ML; Vavilala, MS; Markowitz, AJ; Korley, FK; TRACK-TBI Investigators,

Published Date

  • April 1, 2022

Published In

Volume / Issue

  • 34 / 2

Start / End Page

  • 233 - 237

PubMed ID

  • 33901061

Pubmed Central ID

  • PMC8536798

Electronic International Standard Serial Number (EISSN)

  • 1537-1921

Digital Object Identifier (DOI)

  • 10.1097/ANA.0000000000000772

Language

  • eng

Conference Location

  • United States