Redefining the Prognostic Value of High-Sensitivity Troponin in COVID-19 Patients. The Importance of Concomitant Coronary Artery Disease

Marco Schiavone, Alessio Gasperetti, Massimo Mancone, Aaron V Kaplan, Cecilia Gobbi, Giosuè Mascioli, Mattia Busana, Ardan M Saguner, Gianfranco Mitacchione, Andrea Giacomelli, Gennaro Sardella, Maurizio Viecca, Firat Duru, Spinello Antinori, Stefano Carugo, Antonio L Bartorelli, Claudio Tondo, Massimo Galli, Francesco Fedele, Giovanni B Forleo

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Although studies assessing cardiovascular comorbidities and myocardial injury in Coronavirus disease 2019 (COVID-19) patients have been published, no reports focused on clinical outcomes of myocardial injury in patients with and without chronic coronary syndromes (CCS) are currently available.

METHODS: In this study, consecutive COVID-19 patients admitted to four different institutions were screened for enrolment. Patients were divided into two groups (CCS vs. no-CCS). Association with in-hospital mortality and related predictors represented the main study outcome; myocardial injury and its predictors were deemed secondary outcomes.

RESULTS: A total of 674 COVID-19 patients were enrolled, 112 (16.6%) with an established history of CCS. Myocardial injury occurred in 43.8% patients with CCS vs. 14.4% patients without CCS, as confirmed by high-sensitivity cardiac troponin (hs-cTn) elevation on admission or during hospitalization. The mortality rate in the CCS cohort was nearly three-fold higher. After adjusting for disease severity, myocardial injury resulted significantly associated with in-hospital mortality in the no-CCS group but not in CCS patients.

CONCLUSIONS: Patients with CCS and COVID-19 showed high mortality rate. Myocardial injury may be a bystander in CCS patients and COVID-19, while in patients without known history of CCS, myocardial injury has a significant role in predicting poor outcomes.

Original languageEnglish
JournalJournal of Clinical Medicine
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 12 2020

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