tetano
Editor, Senior Moderator
Int J Cardiol Heart Vasc
. 2023 Apr;45:101196.
doi: 10.1016/j.ijcha.2023.101196. Epub 2023 Mar 16.
Negative Troponin I as a Predictor of Survival in Patients With Coronavirus Disease 2019
Fergie J Losiniecki[SUP] 1 [/SUP], Jose Lopez[SUP] 2 [/SUP], Majd Jazaerly[SUP] 3 [/SUP], Kristina Menchaca[SUP] 4 [/SUP], Vivek Kothari[SUP] 4 [/SUP], Brendon Cornett[SUP] 5 [/SUP], Christopher N Ochner[SUP] 6 [/SUP], Robert Chait[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Despite a large amount of evidence evaluating elevated troponin I levels and adverse clinical outcomes, little is known about the role of a normal (negative) troponin I during the first 24 h of admission for risk stratification in patients with Coronavirus Disease 2019 (COVID-19). This study aims to evaluate the utility and negative predictive value of a serum troponin I level to predict in-hospital mortality.
Methods: We retrospectively analyzed all adult patients (>18 years of age) with COVID-19 admitted to an HCA Healthcare facility between March 2020 and March 2021 who had a troponin I level drawn at admission. Patients were initially stratified into two groups based on their cardiac troponin I value in the first 24 h of admission (elevated vs negative).
Results: A total of 65,580 patients were included in the final analysis. A negative troponin I value was associated with lesser odds of death during admission (OR = 0.32, 95 % CI 0.31-0.34, p < 0.01) and cardiac complications (OR = 0.38, 95 % CI 0.37-0.40, p < 0.01). The negative predictive value of a negative troponin value for all-cause in-hospital mortality was 85.7 %.
Conclusions: Our study found a significant association between a negative troponin I value in the first 24 h of admission and decreased odds of death during admission in patients with confirmed COVID-19 infection, in addition to decreased odds of cardiac complications but no significant difference in hospital length of stay. Therefore, the authors suggest that the absence of troponin I elevation may serve as an indicator of a more benign hospital course.
Keywords: COVID-19; Cardiac Complications; Mortality; Troponin.
. 2023 Apr;45:101196.
doi: 10.1016/j.ijcha.2023.101196. Epub 2023 Mar 16.
Negative Troponin I as a Predictor of Survival in Patients With Coronavirus Disease 2019
Fergie J Losiniecki[SUP] 1 [/SUP], Jose Lopez[SUP] 2 [/SUP], Majd Jazaerly[SUP] 3 [/SUP], Kristina Menchaca[SUP] 4 [/SUP], Vivek Kothari[SUP] 4 [/SUP], Brendon Cornett[SUP] 5 [/SUP], Christopher N Ochner[SUP] 6 [/SUP], Robert Chait[SUP] 3 [/SUP]
Affiliations
- PMID: 36941996
- PMCID: PMC10017385
- DOI: 10.1016/j.ijcha.2023.101196
Abstract
Background: Despite a large amount of evidence evaluating elevated troponin I levels and adverse clinical outcomes, little is known about the role of a normal (negative) troponin I during the first 24 h of admission for risk stratification in patients with Coronavirus Disease 2019 (COVID-19). This study aims to evaluate the utility and negative predictive value of a serum troponin I level to predict in-hospital mortality.
Methods: We retrospectively analyzed all adult patients (>18 years of age) with COVID-19 admitted to an HCA Healthcare facility between March 2020 and March 2021 who had a troponin I level drawn at admission. Patients were initially stratified into two groups based on their cardiac troponin I value in the first 24 h of admission (elevated vs negative).
Results: A total of 65,580 patients were included in the final analysis. A negative troponin I value was associated with lesser odds of death during admission (OR = 0.32, 95 % CI 0.31-0.34, p < 0.01) and cardiac complications (OR = 0.38, 95 % CI 0.37-0.40, p < 0.01). The negative predictive value of a negative troponin value for all-cause in-hospital mortality was 85.7 %.
Conclusions: Our study found a significant association between a negative troponin I value in the first 24 h of admission and decreased odds of death during admission in patients with confirmed COVID-19 infection, in addition to decreased odds of cardiac complications but no significant difference in hospital length of stay. Therefore, the authors suggest that the absence of troponin I elevation may serve as an indicator of a more benign hospital course.
Keywords: COVID-19; Cardiac Complications; Mortality; Troponin.