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Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 ESC+Heart+Fail 2021 ; 8 (5): 3504-3511 Nephropedia Template TP
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The prognostic value of serial troponin measurements in patients admitted for COVID-19 #MMPMID34236135
Nuzzi V; Merlo M; Specchia C; Lombardi CM; Carubelli V; Iorio A; Inciardi RM; Bellasi A; Canale C; Camporotondo R; Catagnano F; Dalla Vecchia LA; Giovinazzo S; Maccagni G; Mapelli M; Margonato D; Monzo L; Oriecuia C; Peveri G; Pozzi A; Provenzale G; Sarullo F; Tomasoni D; Ameri P; Gnecchi M; Leonardi S; Agostoni P; Carugo S; Danzi GB; Guazzi M; La Rovere MT; Mortara A; Piepoli M; Porto I; Volterrani M; Senni M; Metra M; Sinagra G
ESC Heart Fail 2021[Oct]; 8 (5): 3504-3511 PMID34236135show ga
AIMS: Myocardial injury (MI) in coronavirus disease-19 (COVID-19) is quite prevalent at admission and affects prognosis. Little is known about troponin trajectories and their prognostic role. We aimed to describe the early in-hospital evolution of MI and its prognostic impact. METHODS AND RESULTS: We performed an analysis from an Italian multicentre study enrolling COVID-19 patients, hospitalized from 1 March to 9 April 2020. MI was defined as increased troponin level. The first troponin was tested within 24 h from admission, the second one between 24 and 48 h. Elevated troponin was defined as values above the 99th percentile of normal values. Patients were divided in four groups: normal, normal then elevated, elevated then normal, and elevated. The outcome was in-hospital death. The study population included 197 patients; 41% had normal troponin at both evaluations, 44% had elevated troponin at both assessments, 8% had normal then elevated troponin, and 7% had elevated then normal troponin. During hospitalization, 49 (25%) patients died. Patients with incident MI, with persistent MI, and with MI only at admission had a higher risk of death compared with those with normal troponin at both evaluations (P < 0.001). At multivariable analysis, patients with normal troponin at admission and MI injury on Day 2 had the highest mortality risk (hazard ratio 3.78, 95% confidence interval 1.10-13.09, P = 0.035). CONCLUSIONS: In patients admitted for COVID-19, re-test MI on Day 2 provides a prognostic value. A non-negligible proportion of patients with incident MI on Day 2 is identified at high risk of death only by the second measurement.