Early risk stratification is critical in infective endocarditis, where mortality remains high despite advances in therapy. A study published in Archives of Cardiovascular Diseases identified cTnT as a robust prognostic biomarker for this population.

The analysis included 1,095 patients with confirmed infective endocarditis divided by baseline cTnT levels: <12 pg/mL, 12–42 pg/mL, and >42 pg/mL. In-hospital mortality increased stepwise across tertiles (0.3%, 6.6%, 13.7%; P < 0.001), while six-month mortality reached 9.8%. Multivariable logistic modeling showed that log-transformed cTnT independently predicted in-hospital mortality (adjusted OR 2.78; 95% CI 1.85–4.19; P < 0.001). Receiver-operating analysis identified 22 pg/mL as the optimal cut-off, and Kaplan–Meier curves confirmed higher six-month mortality beyond this level (adjusted HR 5.03; 95% CI 2.75–9.23; P < 0.001).

These findings establish elevated cTnT as a clinically meaningful predictor of early death in infective endocarditis. Incorporating troponin-based assessment at admission may refine prognostic evaluation and help guide intensive management strategies in high-risk patients.