Table 3.

Unadjusted and adjusted estimates of associations of cTnT with sepsis and CRP, IL-l, PCT, and NT-proBNP in different troponin groups

Parameter	Unadjusted estimates: effect of factor on cTnT as a percentage per unit cTnT, except sepsis* (95% CI)				Adjusted estimates: effect of factor on cTnT as a percentage per unit cTnT, except sepsis* (95% CI)				Standardized effect sizes for adjusted analysis equivalent to a SD change in the relevant marker
	Effect size (%)	LCI	UCI	P value	Effect size (%)	LCI	UCI	P value	Effect size (%)	LCI	UCI
Patients with definite MI (n = 21)
Sepsis	33	6.0	68	0.01	28.85	1.99	62.79	0.03
CRP	0.13	−0.07	0.33	0.20	0.12	−0.08	0.32	0.25	9.70	−6.16	28.23
IL-6 (log)†	N/A			0.006	N/A			0.02	23.37	3.68	46.80
PCT	1.62	−0.06	3.33	0.06	1.30	−0.42	3.04	0.14	14.20	−4.21	36.15
NT-proBNP	0.00	−0.0003	0.0012	0.23	0.0004	−0.0004	0.0012	0.31	0.01	−0.01	0.02
Patients with a possible MI (n = 51)
Sepsis	10.01	−5.48	28.03	0.22	5.98	−8.81	23.18	0.45
CRP	0.13	0.03	0.23	0.01	0.11	0.01	0.21	0.03	10.08	0.85	20.16
IL-6 (log)†	N/A			<0.001	N/A			<0.001	17.45	8.14	27.56
PCT	1.32	0.36	2.29	0.007	1.20	0.25	2.15	0.01	16.86	3.31	32.17
NT-proBNP	0.00	0.0006	0.0016	<0.001	0.0010	0.0005	0.0015	<0.001	0.02	0.01	0.03
Patients with raised cTnT only (n = 73)
Sepsis	22.12	6.56	39.95	0.004	23.17	4.99	37.80	0.01
CRP	0.09	0.00	0.17	0.045	0.08	0.00	0.16	0.07	7.87	−0.47	16.92
IL-6 (log)†	N/A			0.001	N/A			<0.001	15.68	6.58	25.56
PCT	0.68	0.30	1.07	<0.001	0.70	0.28	1.03	0.001	12.58	5.23	20.45
NT-proBNP	0.00	0.0010	0.0028	<0.001	0.0018	0.0006	0.0024	0.001	0.02	0.01	0.03
Patients without raised cTnT (n = 27)
Sepsis	−1.58	−15.80	15.03	0.84	−8.72	−21.03	5.51	0.22
CRP	0.06	−0.03	0.15	0.16	0.00	−0.08	0.09	0.92	0.36	−6.35	7.55
IL-6 (log)†	N/A			0.31	N/A			0.31	−3.32	−9.45	3.24
PCT	2.86	1.35	4.38	<0.001	2.21	0.89	3.54	0.001	13.74	5.35	22.79
NT-proBNP	0.01	0.0036	0.0089	<0.001	0.0049	0.0025	0.0073	<0.001	0.02	0.01	0.03

Adjusted mixed model gives average cTnT (outcome) after allowing for gender, age, ischemic heart disease, hypertension, RRT use, or creatinine ≥140 μmol/L, diabetes, and any form of vascular disease.

Use of standard effect sizes to estimate equivalent changes in cTnT:

Examples:

Relationship between cTnT and NT-proBNP: the standardised effect size for NT-proBNP in patients with a definite MI is 0.01. To obtain the equivalent change in cTnT for a change in NT-proBNP, calculate the following:

(value + 1)^a where value is the estimate as a proportion, and a is the change in NT-proBNP.

For instance, the value of NT-proBNP is 0.01% (= 0.0001); to compute a 10-unit change, the formula translates into: (0.0001 + 1)¹⁰ = 1.001. This means, for a 10-unit change in NT-proBNP, the associated change of cTnT is 0.001 (i.e., 0.1%).

Impact of sepsis: the adjusted effect size describes the difference in cTnT between those with and without sepsis, e.g., if the value is 28.85%, the mean cTnT is raised by 28.85% in patients with sepsis compared with those without sepsis.

^*Results are presented as the percentage change in cTnT as the inflammatory marker increases by one unit.

^†Since Il-6 was log transformed as well as cTnT, the “one-unit change” estimates are not very meaningful and have been omitted.

CI indicates confidence interval; CRP, C-reactive protein; cTnT, cardiac troponin T; IL-6, interleukin 6; LCI, lower confidence interval; MI, myocardial infarction; NT-proBNP, N-terminal pro-brain natriuretic peptide; PCT, procalcitonin; RRT, renal replacement therapy; UCI, upper confidence interval.