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Xiao X. The mechanistic insights into new-onset atrial fibrillation induced by SARS-CoV-2 infection. Int J Cardiol 2024; 397:131587. [PMID: 37956761 DOI: 10.1016/j.ijcard.2023.131587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Xiaoxia Xiao
- Department of cardiology, The Third Hospital of Changsha, Changsha 410001, China.
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Alsagaff MY, Wardhani LFK, Nugraha RA, Putra TS, Khrisna BPD, Al-Farabi MJ, Gunadi RI, Azmi Y, Budianto CP, Fagi RA, Luthfah N, Subagjo A, Oktaviono YH, Lefi A, Dharmadjati BB, Alkaff FF, Pikir BS. Quantification of hs-Troponin Levels and Global Longitudinal Strain among Critical COVID-19 Patients with Myocardial Involvement. J Clin Med 2024; 13:352. [PMID: 38256486 PMCID: PMC10816186 DOI: 10.3390/jcm13020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Background. Myocardial involvement among critically ill patients with coronavirus disease 2019 (COVID-19) often has worse outcomes. An imbalance in the oxygen supply causes the excessive release of pro-inflammatory cytokines, which results in increased ventilation requirements and the risk of death in COVID-19 patients. Purpose. We evaluated the association between the hs-troponin I levels and global longitudinal strain (GLS) as evidence of myocardial involvement among critical COVID-19 patients. Methods. We conducted a prospective cohort study from 1 February to 31 July 2021 at RSUD Dr. Soetomo, Surabaya, as a COVID-19 referral center. Of the 65 critical COVID-19 patients included, 41 (63.1%) were men, with a median age (interquartile range) of 51.0 years (20.0-75.0). Subjects were recruited based on WHO criteria for severe COVID-19, and myocardial involvement in the form of myocarditis was assessed using CDC criteria. Subjects were examined using echocardiography to measure the GLS, and blood samples were taken to measure the hs-troponin. Subjects were then followed for their need for mechanical ventilation and in-hospital mortality. Results. Severe COVID-19 patients with cardiac injury were associated with an increased need for intubation (78.5%) and an increased incidence of myocarditis (50.8%). There was a relationship between the use of intubation and the risk of death in patients (66.7% vs. 33.3%, p-value < 0.001). Decreased GLS and increased hs-troponin were associated with increased myocarditis (p values < 0.001 and 0.004, respectively). Decreased GLS was associated with a higher need for mechanical ventilation (12.17 + 4.79 vs. 15.65 + 4.90, p-value = 0.02) and higher mortality (11.36 + 4.64 vs. 14.74 + 4.82; p-value = 0.005). Elevated hs-troponin was associated with a higher need for mechanical ventilation (25.33% vs. 3.56%, p-value = 0.002) and higher mortality (34.57% vs. 5.76%, p-value = 0.002). Conclusions. Critically ill COVID-19 patients with myocardial involvement and elevated cardiac troponin levels are associated with a higher need for mechanical ventilation and higher mortality.
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Affiliation(s)
- Mochamad Yusuf Alsagaff
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Louisa Fadjri Kusuma Wardhani
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Tony Santoso Putra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Bagus Putra Dharma Khrisna
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Makhyan Jibril Al-Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Ruth Irena Gunadi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Yusuf Azmi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Christian Pramudita Budianto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Rosi Amrilla Fagi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Nadya Luthfah
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Agus Subagjo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Achmad Lefi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Budi Baktijasa Dharmadjati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | | | - Budi Susetyo Pikir
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
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Jin X, Yang H, Ma W, Yuan Y, Li T. Elevated High Sensitivity Cardiac Troponin T is Nonlinearly Associated with Poor Prognosis in Aging COVID-19 Patients: A Retrospective Study. Infect Drug Resist 2023; 16:5155-5163. [PMID: 37581166 PMCID: PMC10423578 DOI: 10.2147/idr.s422492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023] Open
Abstract
Objective To evaluate the relationship between high-sensitivity cardiac troponin T (hs-cTnT) and prognosis in elderly patients with coronavirus disease 2019 (COVID-19). Methods This study recruited 1399 COVID-19 patients aged 65 years or older admitted to Taizhou Hospital or Enze Hospital in Zhejiang Province from December 15, 2022, to January 4, 2023. The Cox regression model was used to evaluate the relationship between hs-cTnT level and in-hospital death. The logistic regression model was used to evaluate the relationship between hs-cTnT level and major adverse events. The restricted cubic spline (RCS) model is used for nonlinear analysis. Results The increase of peak hs-cTnT was associated with the increased risk of death (HR 9.49; 95% CI 1.19-75.48; trend p = 0.012) and major adverse events (OR 20.59; 95% CI 10.41-40.71; trend p < 0.001). RCS model showed the association between peak hs-cTnT and death and major adverse events were nonlinear (P for non-line < 0.001). Starting from the limit of quantification of hs-cTnT (3ng/L), the risk of death and major adverse events had a steep S-shaped increase until hs-cTnT reached the 90th percentile point (hs-cTnT = 131 ng/L), followed by a plateau period. Peak hs-cTnT has good predictive value for death and major adverse events, with AUC of 0.834 and 0.804, respectively. Conclusion Peak hs-cTnT has high predictive value for the risk of in-hospital death and major adverse events in elderly patients with COVID-19. The association between peak hs-cTnT and death and major adverse events were nonlinear.
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Affiliation(s)
- Xiaxia Jin
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Haideng Yang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Weiwei Ma
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Yuan Yuan
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Tao Li
- Department of Cardiovascular Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
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Burhan E, Mubarak F, Adilah SASU, Sari CYI, Ismail E, Astuti P, Hanifah Y, Wiyarta E, Suryana NM. Association between cardiovascular diseases and COVID-19 pneumonia outcome in Indonesia: a multi-center cohort study. Front Med (Lausanne) 2023; 10:1190148. [PMID: 37457562 PMCID: PMC10339801 DOI: 10.3389/fmed.2023.1190148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Background COVID-19 is a pandemic affecting 185 countries, including Indonesia. Cardiovascular diseases (CVD) in COVID-19 patients were linked to worse clinical outcomes. However, the association remained inconclusive due to limited data in Indonesia. This study aimed to determine the association between CVD in COVID-19 pneumonia patients with its clinical outcomes. Methods This retrospective cohort study was conducted in four Indonesian hospitals, enrolling 584 adult COVID-19 pneumonia patients from September 2020 to July 2021. Patients were categorized into two groups: non-CVD and CVD [hypertension, coronary artery disease (CAD), chronic heart failure (CHF), hypertensive heart disease (HHD), arrhythmia, cardiomegaly, left ventricular hypertrophy (LVH), mitral regurgitation (MR), and myocardial injury (MI)]. Clinical outcomes include in-hospital mortality, intensive care unit admission, ventilator use, earlier death, and prolonged hospital stay. Mann-Whitney test was used for analysis. Results The most common CVD was hypertension (48.1%), followed by MI (10.6%), CAD (9.2%), CHF (6.8%), HHD (3.1%), arrhythmia (1.7%), and others (0.7%). The in-hospital mortality rate was 24%, and patients were hospitalized for a median of 12 days. MI was the only CVD that increased in-hospital mortality (RR 2.105). It was also significantly increased in patients with diabetes mellitus (RR 1.475) and chronic kidney disease (RR 2.079). Meanwhile, prolonged hospital stay was associated with any CVD (RR 1.553), hypertension (RR 1.511), MI (RR 1.969), CHF (RR 1.595), diabetes mellitus (RR 1.359), and cerebrovascular disease (RR 2.203). Conclusion COVID-19 pneumonia in patients with CVD, specifically MI and hypertension, worsens the COVID-19 clinical outcomes.
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Affiliation(s)
- Erlina Burhan
- Department of Pulmonology and Respiratory Medicine, Persahabatan Central General Hospital, Universitas Indonesia, Jakarta, Indonesia
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Farhan Mubarak
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Cut Yulia Indah Sari
- Department of Pulmonology, Jakarta Islam Hospital Cempaka Putih, Jakarta, Indonesia
| | - Efriadi Ismail
- Department of Pulmonology, Yarsi Hospital, Jakarta, Indonesia
| | - Puji Astuti
- Department of Pulmonology, Cengkareng District General Hospital, Jakarta, Indonesia
| | - Yasmina Hanifah
- Department of Cardiology and Vascular Medicine, Persahabatan Central General Hospital, Jakarta, Indonesia
| | - Elvan Wiyarta
- Department of Medical Science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nana Maya Suryana
- Department of Cardiology and Vascular Medicine, Persahabatan Central General Hospital, Jakarta, Indonesia
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De Michieli L, Jaffe AS, Sandoval Y. Use and Prognostic Implications of Cardiac Troponin in COVID-19. Heart Fail Clin 2023; 19:163-176. [PMID: 36863808 PMCID: PMC9973555 DOI: 10.1016/j.hfc.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Myocardial injury is common in patients with COVID-19 and is associated with an adverse prognosis. Cardiac troponin (cTn) is used to detect myocardial injury and assist with risk stratification in this population. SARS-CoV-2 infection can play a role in the pathogenesis of acute myocardial injury due to both direct and indirect damage to the cardiovascular system. Despite the initial concerns about an increased incidence of acute myocardial infarction (MI), most cTn increases are related to chronic myocardial injury due to comorbidities and/or acute nonischemic myocardial injury. This review will discuss the latest findings on this topic.
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Affiliation(s)
- Laura De Michieli
- Department of Cardiovascular Diseases, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA,Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, Padova 35128, Italy
| | - Allan S. Jaffe
- Department of Cardiovascular Diseases, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA,Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA
| | - Yader Sandoval
- Department of Cardiovascular Diseases, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
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Kaye DM, Patel HC. COVID-19-Associated Myocardial Injury: Solving a Mystery Inside an Enigma. JACC Basic Transl Sci 2023; 8:138-140. [PMID: 36875779 PMCID: PMC9970032 DOI: 10.1016/j.jacbts.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- David M Kaye
- Department of Cardiology, Alfred Hospital, Melbourne, Australia.,Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Hitesh C Patel
- Department of Cardiology, Alfred Hospital, Melbourne, Australia.,Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
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Patel G, Smith J, Baloch L, Affinati M, Vasavada A, Reddy S, Jain S, Hassen G, Araya M, Adak S. Prevalence, Predictors, and Outcomes of Myocardial Injury in Hospitalized COVID-19 Patients—An Observational Retrospective Study. Hearts 2022; 3:66-75. [DOI: 10.3390/hearts3030009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
COVID-19 mainly causes pulmonary manifestation; nonetheless, its systemic inflammatory response involves multiple organs, including the heart. We aimed to evaluate the prevalence, predictors, and outcomes of myocardial injury in hospitalized patients with SARS-CoV-2 infection. Methods and Results: We performed an observational retrospective analysis on patients hospitalized with COVID-19 in a moderate-sized community hospital system. Myocardial injury was defined as highly sensitive troponin T levels in the 99th percentile above the normal upper limit for the respective biological sex. Multivariable logistic regression models were fitted to assess the association between the myocardial-injury and the no-myocardial-injury groups for primary and secondary outcomes. A total of 1632 (49.3% male, 41.7% aged 60–79 years) patients with COVID-19 were included, out of which 312 (19.1%) had a myocardial injury. Patients with myocardial injury were older (36.9% > 80 years) and had higher cardiovascular-related comorbidities than those without. The prevalence of cardiovascular risk factors (78.5% vs. 52.0%) and cardiovascular diseases (78.2% vs. 56.1%) was much higher in the myocardial-injury group. Older age (50–64 years vs. <49 years; OR, 3.67 [1.99–6.74]), Angiotensin Receptor Blockers (ARBs) (OR, 1.44 [1.01–2.05]), Beta-blockers (OR, 2.37 [1.80–3.13]), and cardiovascular comorbidities (OR, 1.49 [1.09–2.05]) were strong predictors of cardiac injury after multivariable adjustment. Myocardial injury was strongly associated with ICU admission (adjusted OR, 1.68 [1.29–2.19]) and longer length of hospital stay (median days, 5 (3, 9) vs. 4 (2, 7)). The results do not show a significant difference in the use of mechanical ventilation (OR, 1.29 [0.87–1.89]) or in-hospital mortality (OR, 1.37 [0.98–1.91]) with respect to myocardial injury. Conclusion: This multicenter retrospective study of nearly 1600 patients revealed the following findings: Myocardial injury was observed in 1 out of 5 patients hospitalized with COVID-19 but was more often clinically insignificant. Patients of age > 65 had very high odds of having elevated troponin levels after adjusting for sex and other illnesses. Pre-existing cardiac diseases and risk factors were robust predictors of cardiac injury after adjusting for age and sex. In the adjusted model, myocardial injury was not associated with the requirement of mechanical ventilation or change in in-hospital mortality.
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Motloch LJ, Jirak P, Gareeva D, Davtyan P, Gumerov R, Lakman I, Tataurov A, Zulkarneev R, Kabirov I, Cai B, Valeev B, Pavlov V, Kopp K, Hoppe UC, Lichtenauer M, Fiedler L, Pistulli R, Zagidullin N. Cardiovascular Biomarkers for Prediction of in-hospital and 1-Year Post-discharge Mortality in Patients With COVID-19 Pneumonia. Front Med (Lausanne) 2022; 9:906665. [PMID: 35836945 PMCID: PMC9273888 DOI: 10.3389/fmed.2022.906665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/30/2022] [Indexed: 01/08/2023] Open
Abstract
Aims While COVID-19 affects the cardiovascular system, the potential clinical impact of cardiovascular biomarkers on predicting outcomes in COVID-19 patients is still unknown. Therefore, to investigate this issue we analyzed the prognostic potential of cardiac biomarkers on in-hospital and long-term post-discharge mortality of patients with COVID-19 pneumonia. Methods Serum soluble ST2, VCAM-1, and hs-TnI were evaluated upon admission in 280 consecutive patients hospitalized with COVID-19-associated pneumonia in a single, tertiary care center. Patient clinical and laboratory characteristics and the concentration of biomarkers were correlated with in-hospital [Hospital stay: 11 days (10; 14)] and post-discharge all-cause mortality at 1 year follow-up [FU: 354 days (342; 361)]. Results 11 patients died while hospitalized for COVID-19 (3.9%), and 11 patients died during the 1-year post-discharge follow-up period (n = 11, 4.1%). Using multivariate analysis, VCAM-1 was shown to predict mortality during the hospital period (HR 1.081, CI 95% 1.035;1.129, p = 0.017), but not ST2 or hs-TnI. In contrast, during one-year FU post hospital discharge, ST2 (HR 1.006, 95% CI 1.002;1.009, p < 0.001) and hs-TnI (HR 1.362, 95% CI 1.050;1.766, p = 0.024) predicted mortality, although not VCAM-1. Conclusion In patients hospitalized with Covid-19 pneumonia, elevated levels of VCAM-1 at admission were associated with in-hospital mortality, while ST2 and hs-TnI might predict post-discharge mortality in long term follow-up.
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Affiliation(s)
- Lukas J. Motloch
- University Clinic for Internal Medicine II, Paracelsus Medical University, Salzburg, Austria
- *Correspondence: Lukas J. Motloch
| | - Peter Jirak
- University Clinic for Internal Medicine II, Paracelsus Medical University, Salzburg, Austria
| | - Diana Gareeva
- Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
| | - Paruir Davtyan
- Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
| | - Ruslan Gumerov
- Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
| | - Irina Lakman
- Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
- Department of Biomedical Engineering, Ufa State Aviation Technical University, Ufa, Russia
- Scientific Laboratory for the Socio-Economic Region Problems Investigation, Bashkir State University, Ufa, Russia
| | - Aleksandr Tataurov
- Scientific Laboratory for the Socio-Economic Region Problems Investigation, Bashkir State University, Ufa, Russia
| | - Rustem Zulkarneev
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
| | - Ildar Kabirov
- Department of Urology, Bashkir State Medical University, Ufa, Russia
| | - Benzhi Cai
- Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia
- The Key Laboratory of Cardiovascular Medicine Research, Ministry of Education, Department of Pharmacy at the Second Affiliated Hospital, and Department of Pharmacology at College of Pharmacy, Harbin Medical University, Harbin, China
| | - Bairas Valeev
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
| | - Valentin Pavlov
- Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia
- Department of Urology, Bashkir State Medical University, Ufa, Russia
| | - Kristen Kopp
- University Clinic for Internal Medicine II, Paracelsus Medical University, Salzburg, Austria
| | - Uta C. Hoppe
- University Clinic for Internal Medicine II, Paracelsus Medical University, Salzburg, Austria
| | - Michael Lichtenauer
- University Clinic for Internal Medicine II, Paracelsus Medical University, Salzburg, Austria
| | - Lukas Fiedler
- University Clinic for Internal Medicine II, Paracelsus Medical University, Salzburg, Austria
- Department of Internal Medicine, Cardiology, Nephrology and Intensive Care Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - Rudin Pistulli
- Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Munster, Munster, Germany
| | - Naufal Zagidullin
- Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
- Department of Biomedical Engineering, Ufa State Aviation Technical University, Ufa, Russia
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Rocco E, Grimaldi MC, Maino A, Cappannoli L, Pedicino D, Liuzzo G, Biasucci LM. Advances and Challenges in Biomarkers Use for Coronary Microvascular Dysfunction: From Bench to Clinical Practice. J Clin Med 2022; 11:jcm11072055. [PMID: 35407662 PMCID: PMC8999821 DOI: 10.3390/jcm11072055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/27/2022] [Accepted: 04/02/2022] [Indexed: 02/01/2023] Open
Abstract
Coronary microvascular dysfunction (CMD) is related to a broad variety of clinical scenarios in which cardiac microvasculature is morphologically and functionally affected, and it is associated with impaired responses to vasoactive stimuli. Although the prevalence of CMD involves about half of all patients with chronic coronary syndromes and more than 20% of those with acute coronary syndrome, the diagnosis of CMD is often missed, leading to the underestimation of its clinical importance. The established and validated techniques for the measurement of coronary microvascular function are invasive and expensive. An ideal method to assess endothelial dysfunction should be accurate, non-invasive, cost-effective and accessible. There are varieties of biomarkers available, potentially involved in microvascular disease, but none have been extensively validated in this heterogeneous clinical population. The investigation of potential biomarkers linked to microvascular dysfunction might improve the assessment of the diagnosis, risk stratification, disease progression and therapy response. This review article offers an update about traditional and novel potential biomarkers linked to CMD.
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Affiliation(s)
- Erica Rocco
- Department of Medical-Surgical Sciences and Biotechnologies, Cardiology Unit, ICOT Hospital, Sapienza University of Rome, 04110 Latina, Italy;
| | - Maria Chiara Grimaldi
- Department of Cardiovascular and Pneumological Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (A.M.); (L.C.); (D.P.); (G.L.); (L.M.B.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence:
| | - Alessandro Maino
- Department of Cardiovascular and Pneumological Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (A.M.); (L.C.); (D.P.); (G.L.); (L.M.B.)
| | - Luigi Cappannoli
- Department of Cardiovascular and Pneumological Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (A.M.); (L.C.); (D.P.); (G.L.); (L.M.B.)
| | - Daniela Pedicino
- Department of Cardiovascular and Pneumological Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (A.M.); (L.C.); (D.P.); (G.L.); (L.M.B.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Giovanna Liuzzo
- Department of Cardiovascular and Pneumological Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (A.M.); (L.C.); (D.P.); (G.L.); (L.M.B.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Luigi Marzio Biasucci
- Department of Cardiovascular and Pneumological Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (A.M.); (L.C.); (D.P.); (G.L.); (L.M.B.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Affiliation(s)
- Laura De Michieli
- Department of Cardiovascular Diseases, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, Padova 35128, Italy
| | - Allan S Jaffe
- Department of Cardiovascular Diseases, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA
| | - Yader Sandoval
- Department of Cardiovascular Diseases, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
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11
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Metzler B, Lechner I, Reindl M, Reinstadler SJ. Cardiac injury after COVID-19: Primary cardiac and primary non-cardiac etiology makes a difference. Int J Cardiol 2022; 350:17-18. [PMID: 34979150 PMCID: PMC8719915 DOI: 10.1016/j.ijcard.2021.12.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Bernhard Metzler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
| | - Ivan Lechner
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Martin Reindl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Sebastian J Reinstadler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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12
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Sun B, Wang H, Lv J, Pei H, Bai Z. Predictors of Mortality in Hospitalized COVID-19 Patients Complicated With Hypotension and Hypoxemia: A Retrospective Cohort Study. Front Med (Lausanne) 2021; 8:753035. [PMID: 34778315 PMCID: PMC8581201 DOI: 10.3389/fmed.2021.753035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/05/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction: COVID-19 patients with hypotension and hypoxemia had a significantly worse outcome. The purpose of this research was to ascertain the risk factors affecting the prognoses of these patients and to develop appropriate prognostic prediction tools. Methods: From March 1, 2020, to April 16, 2020, a retrospective cohort analysis of COVID-19 patients with hypotension and hypoxemia was performed. The univariate and multivariate analyses were performed to identify the associated risk factors influencing the prognosis of COVID-19 patients with hypotension and hypoxemia, and the selected variables were then utilized to construct and validate the prediction model for these patients. Results: Three hundred and twenty-seven COVID-19 patients with hypotension and hypoxemia who met the inclusion and exclusion criteria were included in this study. Age, temperature, troponin, and blood glucose were related to mortality in COVID-19 patients with hypotension and hypoxemia in both univariate and multivariate analyses. The MFP model (multiple fractional polynomial model), full model, and stepwise model were utilized to build the prediction model, and their AUCs were, respectively, 0.902 (0.868, 0.936), 0.902 (0.868, 0.936), and 0.902 (0.868, 0.936). Because the sample size for this research was limited, we utilized bootstrapping for internal validation. The AUCs of Bootstrap full and Bootstrap stepwise were 0.902 (0.867, 0.936) and 0.902 (0.868, 0.936), respectively. Conclusion: Age, temperature, troponin, and blood glucose levels were associated with mortality in COVID-19 patients with hypotension and hypoxemia. Additionally, the prediction model developed using the variables above showed a high predictive value for predicting the prognosis of these individuals.
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Affiliation(s)
- Baoni Sun
- Emergency Department, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hai Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Junhua Lv
- Emergency Department, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Honghong Pei
- Emergency Department, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhenghai Bai
- Emergency Department, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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13
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Maloberti A, Biolcati M, Giannattasio C. Troponin elevation in COVID-19 patients: An important stratification biomarker with still some open questions. Int J Cardiol 2021; 341:107-109. [PMID: 34352353 PMCID: PMC8327562 DOI: 10.1016/j.ijcard.2021.07.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 01/18/2023]
Affiliation(s)
- Alessandro Maloberti
- Cardiac Rehabilitation, Cardiology 4, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.
| | - Marco Biolcati
- Cardiac Rehabilitation, Cardiology 4, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy
| | - Cristina Giannattasio
- Cardiac Rehabilitation, Cardiology 4, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
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14
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Gragnano F, Cesaro A, Pelliccia F, Calabrò P. Multimodality evaluation of cardiac injury in COVID-19: Getting to the heart of the matter. Int J Cardiol 2021; 339:243-5. [PMID: 34298070 DOI: 10.1016/j.ijcard.2021.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/21/2022]
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