[Prognostic implications of myocardial injury in patients with and without COVID-19 infection treated in a university hospital].

Autor:	Bardají A; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España.; Universidad Rovira Virgili, Tarragona, España.; Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, España., Carrasquer A; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España.; Universidad Rovira Virgili, Tarragona, España.; Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, España., Sánchez-Giménez R; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España., Lal-Trehan N; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España., Del-Moral-Ronda V; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España., Peiró ÓM; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España., Bonet G; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España., Castilho G; Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España.; Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, España., Fort-Gallifa I; Laboratori Clínic ICS Camp de Tarragona-Terres de l'Ebre, Instituto Catalán de la Salud, Tarragona, España., Benavent C; Laboratori Clínic ICS Camp de Tarragona-Terres de l'Ebre, Instituto Catalán de la Salud, Tarragona, España., Recio G; Laboratori Clínic ICS Camp de Tarragona-Terres de l'Ebre, Instituto Catalán de la Salud, Tarragona, España., Gutiérrez C; Laboratori Clínic ICS Camp de Tarragona-Terres de l'Ebre, Instituto Catalán de la Salud, Tarragona, España., Villavicencio C; Servicio de Cuidados Intensivos, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España., Auguet T; Universidad Rovira Virgili, Tarragona, España.; Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, España.; Servicio de Medicina Interna, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España., Boqué C; Universidad Rovira Virgili, Tarragona, España.; Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, España.; Servicio de Urgencias, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España.
Jazyk:	Spanish; Castilian
Zdroj:	Revista espanola de cardiologia [Rev Esp Cardiol] 2021 Jan; Vol. 74 (1), pp. 24-32. Date of Electronic Publication: 2020 Sep 04.
DOI:	10.1016/j.recesp.2020.08.009
Abstrakt:	Introduction and Objectives: Cardiac troponin, a marker of myocardial injury, is frequently observed in patients with COVID-19 infection. Our objective was to analyze myocardial injury and its prognostic implications in patients with and without COVID-19 infection treated in the same period of time. Methods: The present study included patients treated in a university hospital with cardiac troponin I measurements and with suspected COVID-19 infection, confirmed or ruled out by polymerase chain reaction analysis. The impact was analyzed of cardiac troponin I positivity on 30-day mortality. Results: In total, 433 patients were distributed among the following groups: confirmed COVID-19 (n = 186), 22% with myocardial injury (n = 41); and ruled out COVID-19 (n = 247), 21.5% with myocardial injury (n = 52). The confirmed and ruled out COVID-19 groups had a similar age, sex, and cardiovascular history. Mortality was significantly higher in the confirmed COVID-19 group than in the ruled out group (19.9% vs 5.3%, P < .001). In Cox multivariate regression analysis, cardiac troponin I was a predictor of mortality in both groups (confirmed COVID-19 group: HR, 3.54; 95%CI, 1.70-7.34; P  = .001; ruled out COVID-19 group: HR, 5.57; 95%CI, 1.70-18.20; P  = .004). The predictive model analyzed by ROC curves was similar in the 2 groups ( P  = .701), with AUCs of 0.808 in the confirmed COVID-19 group (0.750-0.865) and 0.812 in the ruled out COVID-19 group (0.760-0.864). Conclusions: Myocardial injury is detected in 1 in every 5 patients with confirmed or ruled out COVID-19 and predicts 30-day mortality to a similar extent in both circumstances. (© 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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