Types of myocardial injury and mid-term outcomes in patients with COVID-19.
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 ANDRESULTS:
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.Keywords
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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