Usefulness of Elevated Troponin to Predict Death in Patients With COVID-19 and Myocardial Injury
| Autor: | Luis Gruberg, Jamie S. Hirsch, Rajiv Jauhar, Shahryar G. Saba, David T. Majure, Charlotte Kvasnovsky |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Population Inflammation macromolecular substances 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine Odds Ratio Humans Medicine Hospital Mortality 030212 general & internal medicine education Survival rate Aged Retrospective Studies education.field_of_study biology SARS-CoV-2 business.industry COVID-19 Retrospective cohort study Odds ratio Middle Aged musculoskeletal system Troponin Confidence interval Hospitalization Survival Rate Logistic Models Predictive value of tests biology.protein Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | The American Journal of Cardiology |
| ISSN: | 0002-9149 |
| Popis: | Highlights • Patients with COVID-19 with elevated troponin have markedly increased risk of death. • Patients with elevated troponin were frequently admitted to intensive care units. • Risk with elevated troponin is independent of acute phase and inflammatory markers. • Risk with elevated troponin is independent of baseline cardiovascular disease. Elevations in troponin levels have been shown to predict mortality in patients with coronavirus disease 2019 (COVID-19). The role of inflammation in myocardial injury remains unclear. We sought to determine the association of elevated troponin with mortality in a large, ethnically diverse population of patients hospitalized with COVID-19, and to determine the association of elevated inflammatory markers with increased troponin levels. We reviewed all patients admitted at our health system with COVID-19 from March 1 to April 27, 2020, who had a troponin assessment within 48 hours of admission. We used logistic regression to calculate odds ratios (ORs) for mortality during hospitalization, controlling for demographics, co-morbidities, and markers of inflammation. Of 11,159 patients hospitalized with COVID-19, 6,247 had a troponin assessment within 48 hours. Of these, 4,426 (71%) patients had normal, 919 (15%) had mildly elevated, and 902 (14%) had severely elevated troponin. Acute phase and inflammatory markers were significantly elevated in patients with mildly and severely elevated troponin compared with normal troponin. Patients with elevated troponin had significantly increased odds of death for mildly elevated compared with normal troponin (adjusted OR, 2.06; 95% confidence interval, 1.68 to 2.53; p < 0.001) and for severely elevated compared with normal troponin (OR, 4.51; 95% confidence interval, 3.66 to 5.54; p < 0.001) independently of elevation in inflammatory markers. In conclusion, patients hospitalized with COVID-19 and elevated troponin had markedly increased mortality compared with patients with normal troponin levels. This risk was independent of cardiovascular co-morbidities and elevated markers of inflammation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect