Markers of myocardial injury in the prediction of short-term COVID-19 prognosis
© 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved..
INTRODUCTION AND OBJECTIVES: COVID-19 is currently causing high mortality and morbidity worldwide. Information on cardiac injury is scarce. We aimed to evaluate cardiovascular damage in patients with COVID-19 and determine the correlation of high-sensitivity cardiac-specific troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) with the severity of COVID-19.
METHODS: We included 872 consecutive patients with confirmed COVID-19 from February to April 2020. We tested 651 patients for high-sensitivity troponin T (hs-TnT) and 506 for NT-proBNP on admission. Cardiac injury was defined as hs-TnT > 14 ng/L, the upper 99th percentile. Levels of NT-proBNP > 300 pg/mL were considered related to some extent of cardiac injury. The primary composite endpoint was 30-day mortality or mechanical ventilation (MV).
RESULTS: Cardiac injury by hs-TnT was observed in 34.6% of our COVID-19 patients. Mortality or MV were higher in cardiac injury than noncardiac injury patients (39.1% vs 9.1%). Hs-TnT and NT-proBNP levels were independent predictors of death or MV (HR, 2.18; 95%CI, 1.23-3.83 and 1.87 (95%CI, 1.05-3.36), respectively) and of mortality alone (HR, 2.91; 95%CI, 1.211-7.04 and 5.47; 95%CI, 2.10-14.26, respectively). NT-ProBNP significantly improved the troponin model discrimination of mortality or MV (C-index 0.83 to 0.84), and of mortality alone (C-index 0.85 to 0.87).
CONCLUSIONS: Myocardial injury measured at admission was a common finding in patients with COVID-19. It reliably predicted the occurrence of mortality and need of MV, the most severe complications of the disease. NT-proBNP improved the prognostic accuracy of hs-TnT.
| Errataetall: |
CommentIn: Rev Esp Cardiol (Engl Ed). 2021 Jul;74(7):566-568. - PMID 33612420 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
Revista espanola de cardiologia - 74(2021), 7 vom: 15. Juli, Seite 576-583 |
| Sprache: |
Spanisch |
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| Weiterer Titel: |
Marcadores de daño miocárdico en la predicción del pronóstico a corto plazo de los pacientes con COVID-19 |
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| Beteiligte Personen: |
Calvo-Fernández, Alicia [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 12.11.2023 published: Print-Electronic CommentIn: Rev Esp Cardiol (Engl Ed). 2021 Jul;74(7):566-568. - PMID 33612420 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.recesp.2020.09.017 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM318287781 |
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| 245 | 1 | 0 | |a Markers of myocardial injury in the prediction of short-term COVID-19 prognosis |
| 246 | 3 | 3 | |a Marcadores de daño miocárdico en la predicción del pronóstico a corto plazo de los pacientes con COVID-19 |
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| 500 | |a CommentIn: Rev Esp Cardiol (Engl Ed). 2021 Jul;74(7):566-568. - PMID 33612420 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a INTRODUCTION AND OBJECTIVES: COVID-19 is currently causing high mortality and morbidity worldwide. Information on cardiac injury is scarce. We aimed to evaluate cardiovascular damage in patients with COVID-19 and determine the correlation of high-sensitivity cardiac-specific troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) with the severity of COVID-19 | ||
| 520 | |a METHODS: We included 872 consecutive patients with confirmed COVID-19 from February to April 2020. We tested 651 patients for high-sensitivity troponin T (hs-TnT) and 506 for NT-proBNP on admission. Cardiac injury was defined as hs-TnT > 14 ng/L, the upper 99th percentile. Levels of NT-proBNP > 300 pg/mL were considered related to some extent of cardiac injury. The primary composite endpoint was 30-day mortality or mechanical ventilation (MV) | ||
| 520 | |a RESULTS: Cardiac injury by hs-TnT was observed in 34.6% of our COVID-19 patients. Mortality or MV were higher in cardiac injury than noncardiac injury patients (39.1% vs 9.1%). Hs-TnT and NT-proBNP levels were independent predictors of death or MV (HR, 2.18; 95%CI, 1.23-3.83 and 1.87 (95%CI, 1.05-3.36), respectively) and of mortality alone (HR, 2.91; 95%CI, 1.211-7.04 and 5.47; 95%CI, 2.10-14.26, respectively). NT-ProBNP significantly improved the troponin model discrimination of mortality or MV (C-index 0.83 to 0.84), and of mortality alone (C-index 0.85 to 0.87) | ||
| 520 | |a CONCLUSIONS: Myocardial injury measured at admission was a common finding in patients with COVID-19. It reliably predicted the occurrence of mortality and need of MV, the most severe complications of the disease. NT-proBNP improved the prognostic accuracy of hs-TnT | ||
| 650 | 4 | |a English Abstract | |
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| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Coronavirus | |
| 650 | 4 | |a Myocardial injury | |
| 650 | 4 | |a NT-proBNP | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a Troponin T | |
| 700 | 1 | |a Izquierdo, Andrea |e verfasserin |4 aut | |
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