Giulio G Stefanini 1,2 , Mauro Chiarito 3,2 , Giuseppe Ferrante 3,2 , Francesco Cannata 3,2 , Elena Azzolini 3,2 , Giacomo Viggiani 3,2 , Andrea De Marco 3,2 , Martina Briani 3,2 , Monica Bocciolone 3,2 , Renato Bragato 3,2 , Elena Corrada 3,2 , Gabriele L Gasparini 3,2 , Manuel Marconi 3,2 , Lorenzo Monti 3,2 , Paolo A Pagnotta 3,2 , Cristina Panico 3,2 , Daniela Pini 3,2 , Damiano Regazzoli 3,2 , Ilaria My 3,2 , Marinos Kallikourdis 3,2 , Michele Ciccarelli 3,2 , Salvatore Badalamenti 3,2 , Alessio Aghemo 3,2 , Bernhard Reimers 3,2 , Gianluigi Condorelli 3,2 Show Affiliations »
Abstract
OBJECTIVE: Risk stratification is crucial to optimise treatment strategies in patients with COVID-19. We aimed to evaluate the impact on mortality of an early assessment of cardiac biomarkers in patients with COVID-19. METHODS: Humanitas Clinical and Research Hospital (Rozzano-Milan, Lombardy, Italy) is a tertiary centre that has been converted to the management of COVID-19. Patients with confirmed COVID-19 were entered in a dedicated database for cohort observational analyses. Outcomes were stratified according to elevated levels (ie, above the upper level of normal) of high-sensitivity cardiac troponin I (hs-TnI), B-type natriuretic peptide (BNP) or both measured within 24 hours after hospital admission. The primary outcome was all-cause mortality. RESULTS: A total of 397 consecutive patients with COVID-19 were included up to 1 April 2020. At the time of hospital admission, 208 patients (52.4%) had normal values for cardiac biomarkers, 90 (22.7%) had elevated both hs-TnI and BNP, 59 (14.9%) had elevated only BNP and 40 (10.1%) had elevated only hs-TnI. The rate of mortality was higher in patients with elevated hs-TnI (22.5%, OR 4.35, 95% CI 1.72 to 11.04), BNP (33.9%, OR 7.37, 95% CI 3.53 to 16.75) or both (55.6%, OR 18.75, 95% CI 9.32 to 37.71) as compared with those without elevated cardiac biomarkers (6.25%). A multivariate analysis identified concomitant elevation of both hs-TnI and BNP as a strong independent predictor of all-cause mortality (OR 3.24, 95% CI 1.06 to 9.93). CONCLUSIONS: An early detection of elevated hs-TnI and BNP predicts mortality in patients with COVID-19. Cardiac biomarkers should be systematically assessed in patients with COVID-19 at the time of hospital admission in order to optimise risk stratification. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
OBJECTIVE: Risk stratification is crucial to optimise treatment strategies in patients with COVID-19 . We aimed to evaluate the impact on mortality of an early assessment of cardiac biomarkers in patients with COVID-19 . METHODS: Humanitas Clinical and Research Hospital (Rozzano-Milan, Lombardy, Italy) is a tertiary centre that has been converted to the management of COVID-19 . Patients with confirmed COVID-19 were entered in a dedicated database for cohort observational analyses. Outcomes were stratified according to elevated levels (ie, above the upper level of normal) of high-sensitivity cardiac troponin I (hs-TnI), B-type natriuretic peptide (BNP ) or both measured within 24 hours after hospital admission. The primary outcome was all-cause mortality . RESULTS: A total of 397 consecutive patients with COVID-19 were included up to 1 April 2020. At the time of hospital admission, 208 patients (52.4%) had normal values for cardiac biomarkers, 90 (22.7%) had elevated both hs-TnI and BNP , 59 (14.9%) had elevated only BNP and 40 (10.1%) had elevated only hs-TnI. The rate of mortality was higher in patients with elevated hs-TnI (22.5%, OR 4.35, 95% CI 1.72 to 11.04), BNP (33.9%, OR 7.37, 95% CI 3.53 to 16.75) or both (55.6%, OR 18.75, 95% CI 9.32 to 37.71) as compared with those without elevated cardiac biomarkers (6.25%). A multivariate analysis identified concomitant elevation of both hs-TnI and BNP as a strong independent predictor of all-cause mortality (OR 3.24, 95% CI 1.06 to 9.93). CONCLUSIONS: An early detection of elevated hs-TnI and BNP predicts mortality in patients with COVID-19 . Cardiac biomarkers should be systematically assessed in patients with COVID-19 at the time of hospital admission in order to optimise risk stratification. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Disease
Gene
Species
Keywords:
cardiac risk factors and prevention; coronary artery disease; global health; myocardial disease; systemic inflammatory diseases
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Substances： See more »
Year: 2020
PMID： 32817312 DOI： 10.1136/heartjnl-2020-317322
Source DB: PubMed Journal: Heart ISSN： 1355-6037 Impact factor: 5.994