Abstract
Background: Coronavirus disease 2019 (COVID-19) emerged as a worldwide health crisis, overwhelming healthcare systems. Elevated cardiac troponin T (cTn T) at admission was associated with increased in-hospital mortality. However, data addressing the role of cTn T in major adverse cardiovascular events (MACE) in COVID-19 are scarce. Therefore, we assessed the role of baseline cTn T and cTn T kinetics for MACE and in-hospital mortality prediction in COVID-19.
Methods: Three hundred and ten patients were included prospectively. One hundred and eight patients were excluded due to incomplete records. Patients were divided into three groups according to cTn T kinetics: ascending, descending, and constant. The cTn T slope was defined as the ratio of the cTn T change over time. The primary and secondary endpoints were MACE and in-hospital mortality.
Results: Two hundred and two patients were included in the analysis (mean age 64.4 ± 16.7 years, 119 [58.9%] males). Mean duration of hospitalization was 14.0 ± 12.3 days. Sixty (29.7%) patients had MACE, and 40 (19.8%) patients died. Baseline cTn T predicted both endpoints (p = 0.047, hazard ratio [HR] 1.805, 95% confidence interval [CI] 1.009-3.231; p = 0.009, HR 2.322, 95% CI 1.234-4.369). Increased cTn T slope predicted mortality (p = 0.041, HR 1.006, 95% CI 1.000-1.011). Constant cTn T was associated with lower MACE and mortality (p = 0.000, HR 3.080, 95% CI 1.914-4.954, p = 0.000, HR 2.851, 95% CI 1.828-4.447).
Conclusions: The present study emphasizes the additional role of cTn T testing in COVID-19 patients for risk stratification and improved diagnostic pathway and management.
Keywords: COVID-19; cardiac troponin; kinetics; major cardiovascular adverse events; mortality; myocardial injury.
【저자키워드】 COVID-19, Mortality, cardiac troponin, Kinetics, major cardiovascular adverse events, myocardial injury., 【초록키워드】 coronavirus disease, Coronavirus disease 2019, diagnostic, Health crisis, cardiac troponin, risk stratification, Kinetics, myocardial injury, Health, management, Patient, pathway, troponin T, age, Admission, in-hospital mortality, Analysis, COVID-19 patient, Healthcare systems, cardiac troponin T, Endpoint, 95% CI, 95% confidence interval, secondary endpoint, hazard ratio, three groups, constant, duration of hospitalization, males, defined, predicted, eight, Increased, three group, baseline, cardiovascular event, cTn, descending, patients died, were excluded, 【제목키워드】 Hospitalized, troponin T,