Vol 28, No 6 (2021)
Original Article
Published online: 2021-09-23

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Troponin T in COVID-19 hospitalized patients: Kinetics matter

Maria-Luiza Luchian1, Andreea Iulia Motoc1, Stijn Lochy1, Julien Magne2, Bram Roosens1, Dries Belsack3, Karen Van den Bussche1, Berlinde von Kemp1, Xavier Galloo1, Clara François1, Esther Scheirlynck1, Sven Boeckstaens1, Tom De Potter4, Lucie Seyler5, Johan van Laethem5, Sophie Hennebicq6, Caroline Weytjens1, Steven Droogmans1, Bernard Cosyns1
Pubmed: 34581431
Cardiol J 2021;28(6):807-815.

Abstract

Background: Coronavirus disease 2019 (COVID-19) emerged as a worldwide health crisis, overwhelming healthcare systems. Elevated cardiac troponin T (cTn T) at admission was associated with increased in-hospital mortality. However, data addressing the role of cTn T in major adverse cardiovascular events (MACE) in COVID-19 are scarce. Therefore, we assessed the role of baseline cTn T and cTn T kinetics for MACE and in-hospital mortality prediction in COVID-19.
Methods: Three hundred and ten patients were included prospectively. One hundred and eight patients were excluded due to incomplete records. Patients were divided into three groups according to cTn T kinetics: ascending, descending, and constant. The cTn T slope was defined as the ratio of the cTn T change over time. The primary and secondary endpoints were MACE and in-hospital mortality.
Results: Two hundred and two patients were included in the analysis (mean age 64.4 ± 16.7 years, 119 [58.9%] males). Mean duration of hospitalization was 14.0 ± 12.3 days. Sixty (29.7%) patients had MACE, and 40 (19.8%) patients died. Baseline cTn T predicted both endpoints (p = 0.047, hazard ratio [HR] 1.805, 95% confidence interval [CI] 1.009–3.231; p = 0.009, HR 2.322, 95% CI 1.234–4.369). Increased cTn T slope predicted mortality (p = 0.041, HR 1.006, 95% CI 1.000–1.011). Constant cTn T was associated with lower MACE and mortality (p = 0.000, HR 3.080, 95% CI 1.914–4.954, p = 0.000, HR 2.851, 95% CI 1.828–4.447).
Conclusions: The present study emphasizes the additional role of cTn T testing in COVID-19 patients for risk stratification and improved diagnostic pathway and management.

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