Cardiac Troponin for Assessment of Myocardial Injury in COVID-19: JACC Review Topic of the Week.
J Am Coll Cardiol
; 76(10): 1244-1258, 2020 Sep 08.
Article
in English
| MEDLINE | ID: covidwho-735195
ABSTRACT
Increases in cardiac troponin indicative of myocardial injury are common in patients with coronavirus disease-2019 (COVID-19) and are associated with adverse outcomes such as arrhythmias and death. These increases are more likely to occur in those with chronic cardiovascular conditions and in those with severe COVID-19 presentations. The increased inflammatory, prothrombotic, and procoagulant responses following severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection increase the risk for acute nonischemic myocardial injury and acute myocardial infarction, particularly type 2 myocardial infarction, because of respiratory failure with hypoxia and hemodynamic instability in critically ill patients. Myocarditis, stress cardiomyopathy, acute heart failure, and direct injury from SARS-CoV-2 are important etiologies, but primary noncardiac conditions, such as pulmonary embolism, critical illness, and sepsis, probably cause more of the myocardial injury. The structured use of serial cardiac troponin has the potential to facilitate risk stratification, help make decisions about when to use imaging, and inform stage categorization and disease phenotyping among hospitalized COVID-19 patients.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Troponin
/
Coronavirus Infections
/
Risk Assessment
/
Pandemics
/
Heart Diseases
Type of study:
Diagnostic study
/
Etiology study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
J Am Coll Cardiol
Year:
2020
Document Type:
Article
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