Biomarkers Predict In-Hospital Major Adverse Cardiac Events in COVID-19 Patients: A Multicenter International Study.
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Henein Michael Y, Mandoli Giulia Elena, Pastore Maria Concetta, Ghionzoli Nicolò, Hasson Fouhad, Nisar Muhammad K, Islam Mohammed, Bandera Francesco, Marrocco-Trischitta Massimiliano M, Baroni Irene, Malagoli Alessandro, Rossi Luca, Biagi Andrea, Citro Rodolfo, Ciccarelli Michele, Silverio Angelo, Biagioni Giulia, Moutiris Joseph A, Vancheri Federico, Mazzola Giovanni, Geraci Giulio, Thomas Liza, Altman Mikhail, Pernow John, Ahmed Mona, Santoro Ciro, Esposito Roberta, Casas Guillem, Fernández-Galera Rubén, Gonzalez Maribel, Rodriguez Palomares Jose, Bytyçi Ibadete, Dini Frank Lloyd, Cameli Paolo, Franchi Federico, Bajraktari Gani, Badano Luigi Paolo, Cameli Matteo
Аннотация
METHODS: We retrospectively included patients hospitalized for COVID-19 from 10 centers. Clinical, biochemical, electrocardiographic, and imaging data at admission and medications were collected. Primary endpoint was a composite of in-hospital CV death, acute heart failure (AHF), acute myocarditis, arrhythmias, acute coronary syndromes (ACS), cardiocirculatory arrest, and pulmonary embolism (PE).
RESULTS: Of the 748 patients included, 141(19%) reached the set endpoint: 49 (7%) CV death, 15 (2%) acute myocarditis, 32 (4%) sustained-supraventricular or ventricular arrhythmias, 14 (2%) cardiocirculatory arrest, 8 (1%) ACS, 41 (5%) AHF, and 39 (5%) PE. Patients with CV events had higher age, body temperature, creatinine, high-sensitivity troponin, white blood cells, and platelet counts at admission and were more likely to have systemic hypertension, renal failure (creatinine ≥ 1.25 mg/dL), chronic obstructive pulmonary disease, atrial fibrillation, and cardiomyopathy. On univariate and multivariate analysis, troponin and renal failure were associated with the composite endpoint. Kaplan-Meier analysis showed a clear divergence of in-hospital composite event-free survival stratified according to median troponin value and the presence of renal failure (Log rank p < 0.001).
CONCLUSIONS: Our findings, derived from a multicenter data collection study, suggest the routine use of biomarkers, such as cardiac troponin and serum creatinine, for in-hospital prediction of CV events in patients with COVID-19.