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Rev Esp Cardiol (Engl Ed) . Markers of myocardial injury in the prediction of short-term COVID-19 prognosis

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  • Rev Esp Cardiol (Engl Ed) . Markers of myocardial injury in the prediction of short-term COVID-19 prognosis


    Rev Esp Cardiol (Engl Ed)


    . 2020 Sep 29;S1885-5857(20)30414-X.
    doi: 10.1016/j.rec.2020.09.011. Online ahead of print.
    Markers of myocardial injury in the prediction of short-term COVID-19 prognosis


    [Article in En, Spanish]

    Alicia Calvo-Fern?ndez 1 , Andrea Izquierdo 1 , Isaac Subirana 2 , Nuria Farr? 3 , Joan Vila 4 , Xavier Dur?n 5 , Marcos Garc?a-Guimaraes 6 , Sandra Valdivielso 7 , Paula Cabero 8 , Cristina Soler 8 , Cora Garc?a-Ribas 7 , Clara Rodr?guez 7 , Marc Llagostera 7 , Diana Moj?n 7 , Miren Vicente 7 , Eduard Sol?-Gonz?lez 7 , Andrea S?nchez-Carpintero 9 , Cristina Tevar 7 , Jaume Marrugat 10 , Beatriz Vaquerizo 11



    Affiliations

    Abstract

    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> 14ng/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.

    Keywords: COVID-19; Coronavirus; Da?o mioc?rdico; Myocardial injury; NT-proBNP; SARS-CoV-2; Troponin T; Troponina T.
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