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Cardiac Troponin for Assessment of Myocardial Injury in COVID-19: JACC Review Topic of the Week.
Sandoval, Yader; Januzzi, James L; Jaffe, Allan S.
  • Sandoval Y; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: https://twitter.com/yadersandoval.
  • Januzzi JL; Division of Cardiology, Massachusetts General Hospital and Cardiometabolic Trials, Baim Institute for Clinical Research, Boston, Massachusetts. Electronic address: https://twitter.com/JJheart_doc.
  • Jaffe AS; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota. Electronic address: jaffe.allan@mayo.edu.
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.
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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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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