Marcadores de daño miocárdico en la predicción del pronóstico a corto plazo de los pacientes con COVID-19
| Autor: | Joan Vila, Miren Vicente, Marcos García-Guimaraes, Marc Llagostera, Xavier Duran, Cora García-Ribas, Núria Farré, Eduard Solé-González, Alicia Calvo-Fernández, Paula Cabero, Cristina Tevar, Isaac Subirana, Clara Rodríguez, Beatriz Vaquerizo, Diana Mojón, Andrea Sánchez-Carpintero, Jaume Marrugat, Cristina Soler, Andrea Izquierdo, Sandra Valdivielso |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_treatment
Artículo Original Disease 030204 cardiovascular system & hematology Daño miocárdico 0302 clinical medicine Risk Factors hs-cTnT high-sensitivity cardiac-specific troponin-T Natriuretic Peptide Brain Natriuretic peptide Medicine myocardial injury hs-cTnT troponina T cardiaca de alta sensibilidad troponin T Troponin T biology NT-proBNP N-terminal pro-B-type natriuretic peptide High mortality General Medicine Prognosis TnT-us troponina T ultrasensible NT-proBNP fracción aminoterminal del propéptido natriurético cerebral Cardiology Cardiology and Cardiovascular Medicine medicine.medical_specialty Coronavirus disease 2019 (COVID-19) SARS-CoV-2 coronavirus 2 del síndrome respiratorio agudo grave Heart Diseases medicine.drug_class SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 Article 03 medical and health sciences Internal medicine SARS-CoV-2 coronavirus del síndrome respiratorio agudo grave de tipo 2 Humans In patient Mechanical ventilation Troponina T SARS-CoV-2 business.industry Myocardium COVID-19 Troponin Respiration Artificial Peptide Fragments Coronavirus NT-proBNP biology.protein business Humanities Biomarkers |
| Zdroj: | Revista Espanola De Cardiologia (English Ed.) Revista Espanola De Cardiologia Revista Española de Cardiología |
| ISSN: | 0300-8932 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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