Negative Troponin I as a Predictor of Survival in Patients With Coronavirus Disease 2019.

Autor:	Losiniecki FJ; Division of Electrophysiology, Medical University of South Carolina, Charleston, SC, United States., Lopez J; Department of Internal Medicine, HCA Florida Aventura Hospital, Aventura, FL, United States., Jazaerly M; Division of Cardiology, University of Miami/HCA Florida JFK Hospital, Atlantis, FL, United States., Menchaca K; Department of Internal Medicine, University of Miami/HCA Florida JFK Hospital, Atlantis, FL, United States., Kothari V; Department of Internal Medicine, University of Miami/HCA Florida JFK Hospital, Atlantis, FL, United States., Cornett B; Department of Graduate Medical Education, HCA Healthcare, Brentwood, TN, United States., Ochner CN; East Florida Division Graduate Medical Education, HCA Healthcare, Fort Lauderdale, FL, United States., Chait R; Division of Cardiology, University of Miami/HCA Florida JFK Hospital, Atlantis, FL, United States.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2023 Apr; Vol. 45, pp. 101196. Date of Electronic Publication: 2023 Mar 16.
DOI:	10.1016/j.ijcha.2023.101196
Abstrakt:	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. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Authors.)
Databáze:	MEDLINE
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