Heterogeneity in association of myocardial injury and mortality in sepsis or acute respiratory distress syndrome by subphenotype: a retrospective study
Authors' conclusion
Admission peak troponin-I is significantly associated with 60-day mortality in patients with sepsis or ARDS. This association was distinctly driven by the hypoinflammatory subphenotype.
Study context
- Population
- ICU patients with sepsis or acute respiratory distress syndrome (ARDS) with troponin-I measured between hospital presentation and within 24 h of ICU admission (EARLI derivation, VALID validation cohorts)EARLI n = 597
- Exposure
- Hypoinflammatory vs Hyperinflammatory
- Outcome
- Association between peak troponin-I and 60-day in-hospital mortality within each subphenotype (logistic regression, adjusted)
- Follow-up
- 60 days
Methodological detailssecondary analysis of two prospective observational cohorts, derivation and validation cohorts, latent class analysis derived subphenotypes
- Secondary analysis of two prospective observational cohorts
- Derivation and validation cohorts
- Latent class analysis derived subphenotypes
Main finding
As reported in the abstract
Adjusted odds of 60-day mortality per doubling of peak troponin-I, by subphenotype
HypoinflammatoryAdjusted odds ratio (95% CI)
EARLI, per doubling of peak troponin-I
1.14(1.02–1.28)
VALID, per doubling of peak troponin-I
1.11(1.03–1.21)
Per doubling of peak troponin-I, as printed
Observational data: associations, not effects.
Further findings
Median peak troponin-I by subphenotype
- EARLI: Hyperinflammatory vs Hypoinflammatory (ng/mL)
- 0.07 vs 0.04
- VALID: Hyperinflammatory vs Hypoinflammatory (ng/mL)
- 0.17 vs 0.07
- Both p < 0.05
Original publication
Heterogeneity in association of myocardial injury and mortality in sepsis or acute respiratory distress syndrome by subphenotype: a retrospective study. Crit Care. Published 19 August 2025. doi:10.
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