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Types of myocardial injury and mid-term outcomes in patients with COVID-19.
Kini, Annapoorna; Cao, Davide; Nardin, Matteo; Sartori, Samantha; Zhang, Zhongjie; Pivato, Carlo Andrea; Chiarito, Mauro; Nicolas, Johny; Vengrenyuk, Yuliya; Krishnamoorthy, Parasuram; Sharma, Samin K; Dangas, George; Fuster, Valentin; Mehran, Roxana.
  • Kini A; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
  • Cao D; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
  • Nardin M; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
  • Sartori S; Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.
  • Zhang Z; Division of Medicine, ASST Spedali Civili, Brescia, Italy.
  • Pivato CA; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
  • Chiarito M; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
  • Nicolas J; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
  • Vengrenyuk Y; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
  • Krishnamoorthy P; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Sharma SK; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
  • Dangas G; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
  • Fuster V; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Mehran R; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
Eur Heart J Qual Care Clin Outcomes ; 7(5): 438-446, 2021 09 16.
Article in English | MEDLINE | ID: covidwho-1377964
ABSTRACT

AIMS:

To evaluate the acute and chronic patterns of myocardial injury among patients with coronavirus disease-2019 (COVID-19), and their mid-term outcomes. METHODS AND

RESULTS:

Patients with laboratory-confirmed COVID-19 who had a hospital encounter within the Mount Sinai Health System (New York City) between 27 February 2020 and 15 October 2020 were evaluated for inclusion. Troponin levels assessed between 72 h before and 48 h after the COVID-19 diagnosis were used to stratify the study population by the presence of acute and chronic myocardial injury, as defined by the Fourth Universal Definition of Myocardial Infarction. Among 4695 patients, those with chronic myocardial injury (n = 319, 6.8%) had more comorbidities, including chronic kidney disease and heart failure, while acute myocardial injury (n = 1168, 24.9%) was more associated with increased levels of inflammatory markers. Both types of myocardial injury were strongly associated with impaired survival at 6 months [chronic hazard ratio (HR) 4.17, 95% confidence interval (CI) 3.44-5.06; acute HR 4.72, 95% CI 4.14-5.36], even after excluding events occurring in the first 30 days (chronic HR 3.97, 95% CI 2.15-7.33; acute HR 4.13, 95% CI 2.75-6.21). The mortality risk was not significantly different in patients with acute as compared with chronic myocardial injury (HR 1.13, 95% CI 0.94-1.36), except for a worse prognostic impact of acute myocardial injury in patients <65 years of age (P-interaction = 0.043) and in those without coronary artery disease (P-interaction = 0.041).

CONCLUSION:

Chronic and acute myocardial injury represent two distinctive patterns of cardiac involvement among COVID-19 patients. While both types of myocardial injury are associated with impaired survival at 6 months, mortality rates peak in the early phase of the infection but remain elevated even beyond 30 days during the convalescent phase.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Troponin / COVID-19 / Myocardial Infarction Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur Heart J Qual Care Clin Outcomes Year: 2021 Document Type: Article Affiliation country: Ehjqcco

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Troponin / COVID-19 / Myocardial Infarction Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur Heart J Qual Care Clin Outcomes Year: 2021 Document Type: Article Affiliation country: Ehjqcco