tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Andrea Izquierdo[SUP] 1 [/SUP], Isaac Subirana[SUP] 2 [/SUP], Nuria Farr?[SUP] 3 [/SUP], Joan Vila[SUP] 4 [/SUP], Xavier Dur?n[SUP] 5 [/SUP], Marcos Garc?a-Guimaraes[SUP] 6 [/SUP], Sandra Valdivielso[SUP] 7 [/SUP], Paula Cabero[SUP] 8 [/SUP], Cristina Soler[SUP] 8 [/SUP], Cora Garc?a-Ribas[SUP] 7 [/SUP], Clara Rodr?guez[SUP] 7 [/SUP], Marc Llagostera[SUP] 7 [/SUP], Diana Moj?n[SUP] 7 [/SUP], Miren Vicente[SUP] 7 [/SUP], Eduard Sol?-Gonz?lez[SUP] 7 [/SUP], Andrea S?nchez-Carpintero[SUP] 9 [/SUP], Cristina Tevar[SUP] 7 [/SUP], Jaume Marrugat[SUP] 10 [/SUP], Beatriz Vaquerizo[SUP] 11 [/SUP]
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.
. 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[SUP] 1 [/SUP], Andrea Izquierdo[SUP] 1 [/SUP], Isaac Subirana[SUP] 2 [/SUP], Nuria Farr?[SUP] 3 [/SUP], Joan Vila[SUP] 4 [/SUP], Xavier Dur?n[SUP] 5 [/SUP], Marcos Garc?a-Guimaraes[SUP] 6 [/SUP], Sandra Valdivielso[SUP] 7 [/SUP], Paula Cabero[SUP] 8 [/SUP], Cristina Soler[SUP] 8 [/SUP], Cora Garc?a-Ribas[SUP] 7 [/SUP], Clara Rodr?guez[SUP] 7 [/SUP], Marc Llagostera[SUP] 7 [/SUP], Diana Moj?n[SUP] 7 [/SUP], Miren Vicente[SUP] 7 [/SUP], Eduard Sol?-Gonz?lez[SUP] 7 [/SUP], Andrea S?nchez-Carpintero[SUP] 9 [/SUP], Cristina Tevar[SUP] 7 [/SUP], Jaume Marrugat[SUP] 10 [/SUP], Beatriz Vaquerizo[SUP] 11 [/SUP]
Affiliations
- PMID: 33153955
- DOI: 10.1016/j.rec.2020.09.011
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.