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Clinical impact and predictors of troponin elevation in patients with COVID-19.

MedStar author(s):

Abramowitz, Jonathan

Citation: Cardiovascular Revascularization Medicine. 2021 Mar 05PMID: 34053871Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Advanced Cardiac Catheterization Research Fellowship | Interventional Cardiology FellowshipForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021 Local holdings: Available in print through MWHC library: 2002 - presentISSN:

1878-0938

Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Cardiac involvement in coronavirus disease 2019 (COVID-19) is known, manifested by troponin elevation. Studies in the initial phase of the pandemic demonstrated that these patients tended to have a worse prognosis than patients without myocardial injury. We sought to evaluate the clinical impact of significant troponin elevation in COVID-19-positive patients, along with predictors of poor outcomes, over the span of the pandemic to date.CONCLUSION: COVID-19 patients with troponin elevation are at higher risk for mechanical ventilation and mortality. Efforts should focus on early recognition, evaluation, and intensifying care of these patients. Copyright (c) 2021. Published by Elsevier Inc.METHODS: We analyzed COVID-19-positive patients who presented to the MedStar Health system (11 hospitals in Washington, DC, and Maryland) during the pandemic (March 1-June 30, 2020). We compared clinical course and outcomes based on the presence of troponin elevation and identified predictors of mortality.RESULTS: The cohort included 2716 COVID-19-positive admitted patients for whom troponin was drawn. Of these patients, 250 had troponin elevation (>=1.0 ng/mL). In the troponin-elevation arm, the minimum troponin level was 1.9 +/- 8.82 ng/mL; maximum elevation was 10.23 +/- 31.07 ng/mL. The cohort's mean age was 68.0 +/- 15.0 years; 52.8% were men. Most (68.5%) COVID-19-positive patients with troponin elevation were African American. Patients with troponin elevation tended to be older, with more co-morbidities, and most required mechanical ventilation. In-hospital mortality was significantly higher (48.4%) in COVID-19-positive patients with concomitant troponin elevation than without troponin elevation (12.2%; p < 0.001).All authors: Abramowitz J, Ben-Dor I, Case BC, Forrestal BJ, Hashim H, Medranda GA, Rappaport H, Rogers T, Satler LF, Shea C, Waksman R, Yerasi C, Zhang CFiscal year: FY2021 Digital Object Identifier:

https://dx.doi.org/10.1016/j.carrev.2021.03.002

Date added to catalog: 2021-06-28

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	34053871	Available		34053871

Available in print through MWHC library: 2002 - present

BACKGROUND: Cardiac involvement in coronavirus disease 2019 (COVID-19) is known, manifested by troponin elevation. Studies in the initial phase of the pandemic demonstrated that these patients tended to have a worse prognosis than patients without myocardial injury. We sought to evaluate the clinical impact of significant troponin elevation in COVID-19-positive patients, along with predictors of poor outcomes, over the span of the pandemic to date.

CONCLUSION: COVID-19 patients with troponin elevation are at higher risk for mechanical ventilation and mortality. Efforts should focus on early recognition, evaluation, and intensifying care of these patients. Copyright (c) 2021. Published by Elsevier Inc.

METHODS: We analyzed COVID-19-positive patients who presented to the MedStar Health system (11 hospitals in Washington, DC, and Maryland) during the pandemic (March 1-June 30, 2020). We compared clinical course and outcomes based on the presence of troponin elevation and identified predictors of mortality.

RESULTS: The cohort included 2716 COVID-19-positive admitted patients for whom troponin was drawn. Of these patients, 250 had troponin elevation (>=1.0 ng/mL). In the troponin-elevation arm, the minimum troponin level was 1.9 +/- 8.82 ng/mL; maximum elevation was 10.23 +/- 31.07 ng/mL. The cohort's mean age was 68.0 +/- 15.0 years; 52.8% were men. Most (68.5%) COVID-19-positive patients with troponin elevation were African American. Patients with troponin elevation tended to be older, with more co-morbidities, and most required mechanical ventilation. In-hospital mortality was significantly higher (48.4%) in COVID-19-positive patients with concomitant troponin elevation than without troponin elevation (12.2%; p < 0.001).

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