# Characterizing contemporary practices in the approach to elevated troponin I levels during sepsis

> **NIH NIH F32** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2021 · $53,505

## Abstract

PROJECT SUMMARY/ABSTRACT
I propose the “Characterizing contemporary practices in the approach to elevated troponin I levels during
sepsis” study to develop an evidenced-based approach to the management of elevated serum troponin levels
during sepsis and to advance my skillset in clinical design, data science methodology, statistical programming
and professional development in order to become an independent clinical investigator. Sepsis is the result of
life-threatening organ dysfunction due to infection and is associated with significant long-term cardiovascular
morbidity. Serum troponin levels are frequently elevated during sepsis and are prognostic for post-sepsis
cardiovascular complications. Despite its prognostic significance and regular presence during sepsis, there is
no standardized management approach to patients with elevated serum troponin levels during sepsis.
Decisions regarding cardiovascular diagnostic testing and use of potential cardio-protective medications
among these patients are left to the discretion of the treating clinician, resulting in diverse practice approaches
with unclear impact on patient outcomes. I propose two essential foundational steps needed to develop a
standardized management approach to patients with elevated serum troponin levels during sepsis through the
use of a large, observational critical care database: 1) evaluate current practices in cardiovascular diagnostic
and therapeutic management of patients with elevated serum troponin levels during sepsis, and 2) assess the
risks and benefits associated with use of anti-platelet and anticoagulation strategies as potential cardio-
protective treatment agents, among the same sepsis cohort. The first objective will be achieved through
practice variation analysis using risk-adjusted hierarchical models to identify the patient-, physician-, and
hospital-level factors contributing to cardiac management approach variation. The second objective will be
completed through a targeted trial approach using marginal structural models to estimate the average
treatment effect of each treatment strategy on clinical outcomes. Completion of this proposal will fill knowledge
gaps in current practice strategies as well as assess the risks and benefits of two classes of potential cardio-
protective medications employed in management of patients with elevated serum troponin levels during sepsis.
This work with inform my future application for a mentored Career Development Award geared toward
randomized comparative effectiveness studies of potential cardio-protective medications with the goal of
reducing cardiovascular complications following sepsis hospitalization. This proposal will serve as the
foundation to my career as a leading physician-scientist in critical care health services and comparative
effectiveness research with a focus on the management of the cardiovascular complications of non-cardiac
critical illness.

## Key facts

- **NIH application ID:** 10314392
- **Project number:** 1F32HL160062-01
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Michael Anthony Garcia
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $53,505
- **Award type:** 1
- **Project period:** 2021-09-15 → 2022-06-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10314392

## Citation

> US National Institutes of Health, RePORTER application 10314392, Characterizing contemporary practices in the approach to elevated troponin I levels during sepsis (1F32HL160062-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10314392. Licensed CC0.

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