TY - JOUR
T1 - The prognostic value of serial troponin measurements in patients admitted for COVID-19
AU - Nuzzi, Vincenzo
AU - Merlo, Marco
AU - Specchia, Claudia
AU - Lombardi, Carlo Mario
AU - Carubelli, Valentina
AU - Iorio, Annamaria
AU - Inciardi, Riccardo Maria
AU - Bellasi, Antonio
AU - Canale, Claudia
AU - Camporotondo, Rita
AU - Catagnano, Francesco
AU - Dalla Vecchia, Laura Adelaide
AU - Giovinazzo, Stefano
AU - Maccagni, Gloria
AU - Mapelli, Massimo
AU - Margonato, Davide
AU - Monzo, Luca
AU - Oriecuia, Chiara
AU - Peveri, Giulia
AU - Pozzi, Andrea
AU - Provenzale, Giovanni
AU - Sarullo, Filippo
AU - Tomasoni, Daniela
AU - Ameri, Pietro
AU - Gnecchi, Massimiliano
AU - Leonardi, Sergio
AU - Agostoni, Piergiuseppe
AU - Carugo, Stefano
AU - Danzi, Gian Battista
AU - Guazzi, Marco
AU - La Rovere, Maria Teresa
AU - Mortara, Andrea
AU - Piepoli, Massimo
AU - Porto, Italo
AU - Volterrani, Maurizio
AU - Senni, Michele
AU - Metra, Marco
AU - Sinagra, Gianfranco
N1 - Funding Information:
Dr Carubelli received consulting honoraria from CVie Therapeutics Limited, Servier, and Windtree Therapeutics outside the submitted work. Dr Ameri reported having received speaker and advisor honoraria from Novartis, AstraZeneca, Vifor, Daiichi Sankyo, Boehringer Ingelheim, Pfizer, GlaxoSmithKline, and Merck, Sharp & Dohme and nonfinancial support from Actelion outside the submitted work. Dr Leonardi reported grants and personal fees from AstraZeneca and personal fees from BMS/Pfizer, Novo Nordisk, and Chiesi outside the submitted work. Dr Agostoni reported nonfinancial support from Menarini, Novartis, and Boehringer; grants from Daiichiò Sankyo and Bayer; and grants and nonfinancial support from Actelion outside the submitted work. Dr Mortara reports personal consulting honoraria from Novartis, Servier, Astra Zeneca for participation to advisory board meetings and receives grants from Novartis and Niccomo for research trials. Dr Piepoli reported having received research grants and speaking fees from Novartis, Servier, and TRX and nonfinancial support from Vifor outside the submitted work. Dr Metra reported personal consulting honoraria from Abbott Vascular, Amgen, Bayer, Edwards Therapeutics, Servier, Vifor Pharma, and Windtree Therapeutics for participation to advisory board meetings and executive committees of clinical trials. Dr Senni reported personal fees from Novartis, Abbott, Merck, Bayer, Boehringer, Vifor, and AstraZeneca outside the submitted work.
Publisher Copyright:
© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2021
Y1 - 2021
N2 - Aims: Myocardial injury (MI) in coronavirus disease-19 (COVID-19) is quite prevalent at admission and affects prognosis. Little is known about troponin trajectories and their prognostic role. We aimed to describe the early in-hospital evolution of MI and its prognostic impact. Methods and results: We performed an analysis from an Italian multicentre study enrolling COVID-19 patients, hospitalized from 1 March to 9 April 2020. MI was defined as increased troponin level. The first troponin was tested within 24 h from admission, the second one between 24 and 48 h. Elevated troponin was defined as values above the 99th percentile of normal values. Patients were divided in four groups: normal, normal then elevated, elevated then normal, and elevated. The outcome was in-hospital death. The study population included 197 patients; 41% had normal troponin at both evaluations, 44% had elevated troponin at both assessments, 8% had normal then elevated troponin, and 7% had elevated then normal troponin. During hospitalization, 49 (25%) patients died. Patients with incident MI, with persistent MI, and with MI only at admission had a higher risk of death compared with those with normal troponin at both evaluations (P < 0.001). At multivariable analysis, patients with normal troponin at admission and MI injury on Day 2 had the highest mortality risk (hazard ratio 3.78, 95% confidence interval 1.10–13.09, P = 0.035). Conclusions: In patients admitted for COVID-19, re-test MI on Day 2 provides a prognostic value. A non-negligible proportion of patients with incident MI on Day 2 is identified at high risk of death only by the second measurement.
AB - Aims: Myocardial injury (MI) in coronavirus disease-19 (COVID-19) is quite prevalent at admission and affects prognosis. Little is known about troponin trajectories and their prognostic role. We aimed to describe the early in-hospital evolution of MI and its prognostic impact. Methods and results: We performed an analysis from an Italian multicentre study enrolling COVID-19 patients, hospitalized from 1 March to 9 April 2020. MI was defined as increased troponin level. The first troponin was tested within 24 h from admission, the second one between 24 and 48 h. Elevated troponin was defined as values above the 99th percentile of normal values. Patients were divided in four groups: normal, normal then elevated, elevated then normal, and elevated. The outcome was in-hospital death. The study population included 197 patients; 41% had normal troponin at both evaluations, 44% had elevated troponin at both assessments, 8% had normal then elevated troponin, and 7% had elevated then normal troponin. During hospitalization, 49 (25%) patients died. Patients with incident MI, with persistent MI, and with MI only at admission had a higher risk of death compared with those with normal troponin at both evaluations (P < 0.001). At multivariable analysis, patients with normal troponin at admission and MI injury on Day 2 had the highest mortality risk (hazard ratio 3.78, 95% confidence interval 1.10–13.09, P = 0.035). Conclusions: In patients admitted for COVID-19, re-test MI on Day 2 provides a prognostic value. A non-negligible proportion of patients with incident MI on Day 2 is identified at high risk of death only by the second measurement.
KW - COVID-19
KW - COVID-19 outcome
KW - Myocardial injury
KW - Troponin trajectories
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U2 - 10.1002/ehf2.13462
DO - 10.1002/ehf2.13462
M3 - Article
AN - SCOPUS:85109356404
JO - ESC heart failure
JF - ESC heart failure
SN - 2055-5822
ER -