Coronavirus disease 2019 in patients with cardiovascular disease: clinical features and implications on cardiac biomarkers assessment.
J Cardiovasc Med (Hagerstown)
; 22(11): 832-839, 2021 11 01.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1394702
ABSTRACT
INTRODUCTION:
Previous cardiovascular disease (CVD) and myocardial involvement are common in coronavirus disease-19 (COVID-19). We investigated relationships between CVD, cardiac biomarkers and outcome in COVID-19.METHODS:
We analyzed nâ=â252 patients from a multicenter study and provided comparison according to the presence or absence of underlying CVD. Cardiac biomarkers high-sensitivity Troponin [upper reference of normality (URN) 35âpg/ml for Troponin I and 14âpg/ml for Troponin T] and natriuretic peptides (Nt-pro-B-type natriuretic peptide, URN 300âpg/ml and B-type natriuretic peptide, URN 100âpg/ml) were both available in nâ=â136.RESULTS:
Mean age was 69â±â16âyears (56% men, 31% with previous CVD). Raised hs-Troponin and natriuretic peptides were detected in 36 and 50% of the cases respectively. Age, chronic obstructive pulmonary disease, hemoglobin, hs-Troponin and natriuretic peptides were independently associated with underlying CVD (Pâ<â0.05 for all). Compared with the normal biomarkers subgroups, patients with isolated hs-Troponin elevation had higher in-hospital mortality (31 vs. 4%, Pâ<â0.05), similar CVD prevalence (15 vs. 11%) and trend towards higher D-dimer (930 vs. 397âng/ml, Pâ=â0.140). Patients with both biomarkers elevated had higher age, D-dimer, CVD and in-hospital mortality prevalence compared with other subgroups (all Pâ<â0.05 for trend). Outcome analysis revealed previous CVD [model 1 OR 2.72 (95% CI 1.14-6.49), Pâ=â0.024. model 2 OR 2.65 (95% CI 1.05-6.71), Pâ=â0.039], hs-Troponin (log10) [OR 2.61 (95% CI 1.21-5.66), Pâ=â0.015] and natriuretic peptides (log10) [OR 5.84 (95%CI 2.43-14), Pâ<â0.001] to be independently associated with in-hospital mortality.CONCLUSION:
In our population, previous CVD was part of a vulnerable phenotype including older age, comorbidities, increased cardiac biomarkers and worse prognosis. Patients with isolated increase in hs-Troponin suffered higher mortality rates despite low prevalence of CVD, possibly explained by higher COVID-19-related systemic involvement.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Troponina
/
Enfermedades Cardiovasculares
/
Péptidos Natriuréticos
/
COVID-19
Tipo de estudio:
Estudios diagnósticos
/
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
Europa
Idioma:
Inglés
Revista:
J Cardiovasc Med (Hagerstown)
Asunto de la revista:
Angiología
/
Cardiología
Año:
2021
Tipo del documento:
Artículo
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