Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study
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Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19 : A Danish nationwide registry-based cohort study. / Polcwiartek, Christoffer; Krogager, Maria L; Andersen, Mikkel P; Butt, Jawad H; Pallisgaard, Jannik; Fosbøl, Emil; Schou, Morten; Bhatt, Deepak L; Singh, Avinainder; Køber, Lars; Gislason, Gunnar H; Bang, Casper N; Torp-Pedersen, Christian; Kragholm, Kristian; Pareek, Manan.
I: American heart journal plus : cardiology research and practice, Bind 14, 100131, 2022.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19
T2 - A Danish nationwide registry-based cohort study
AU - Polcwiartek, Christoffer
AU - Krogager, Maria L
AU - Andersen, Mikkel P
AU - Butt, Jawad H
AU - Pallisgaard, Jannik
AU - Fosbøl, Emil
AU - Schou, Morten
AU - Bhatt, Deepak L
AU - Singh, Avinainder
AU - Køber, Lars
AU - Gislason, Gunnar H
AU - Bang, Casper N
AU - Torp-Pedersen, Christian
AU - Kragholm, Kristian
AU - Pareek, Manan
N1 - © 2022 The Authors.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Although troponin elevation is associated with worse outcomes among patients with coronavirus disease 2019 (COVID-19), prognostic implications of serial troponin testing are lacking. We investigated the association between serial troponin measurements and adverse COVID-19 outcomes.METHODS: Using Danish registries, we identified COVID-19 patients with a high-sensitivity troponin measurement followed by a second measurement within 1-24 h. All measurements during follow-up were also utilized in subsequent time-varying analyses. We assessed all-cause mortality associated with the absence/presence of myocardial injury (≥1 troponin measurement >99th percentile upper reference limit) and absence/presence of dynamic troponin changes (>20% relative change if first measurement elevated, >50% relative change if first measurement normal).RESULTS: Of 346 included COVID-19 patients, 56% had myocardial injury. Overall, 20% had dynamic troponin changes. In multivariable Cox regression models, myocardial injury was associated with all-cause mortality (HR = 2.56, 95%CI = 1.46-4.51), as were dynamic troponin changes (HR = 1.66, 95%CI = 1.04-2.64). We observed a low incidence of myocardial infarction (4%) and invasive coronary procedures (4%) among patients with myocardial injury.CONCLUSIONS: Myocardial injury and dynamic troponin changes determined using serial high-sensitivity troponin testing were associated with poor prognosis among patients with COVID-19. The risk of developing myocardial infarction requiring invasive management during COVID-19 hospitalization was low.
AB - BACKGROUND: Although troponin elevation is associated with worse outcomes among patients with coronavirus disease 2019 (COVID-19), prognostic implications of serial troponin testing are lacking. We investigated the association between serial troponin measurements and adverse COVID-19 outcomes.METHODS: Using Danish registries, we identified COVID-19 patients with a high-sensitivity troponin measurement followed by a second measurement within 1-24 h. All measurements during follow-up were also utilized in subsequent time-varying analyses. We assessed all-cause mortality associated with the absence/presence of myocardial injury (≥1 troponin measurement >99th percentile upper reference limit) and absence/presence of dynamic troponin changes (>20% relative change if first measurement elevated, >50% relative change if first measurement normal).RESULTS: Of 346 included COVID-19 patients, 56% had myocardial injury. Overall, 20% had dynamic troponin changes. In multivariable Cox regression models, myocardial injury was associated with all-cause mortality (HR = 2.56, 95%CI = 1.46-4.51), as were dynamic troponin changes (HR = 1.66, 95%CI = 1.04-2.64). We observed a low incidence of myocardial infarction (4%) and invasive coronary procedures (4%) among patients with myocardial injury.CONCLUSIONS: Myocardial injury and dynamic troponin changes determined using serial high-sensitivity troponin testing were associated with poor prognosis among patients with COVID-19. The risk of developing myocardial infarction requiring invasive management during COVID-19 hospitalization was low.
U2 - 10.1016/j.ahjo.2022.100131
DO - 10.1016/j.ahjo.2022.100131
M3 - Journal article
C2 - 35463196
VL - 14
JO - American heart journal plus : cardiology research and practice
JF - American heart journal plus : cardiology research and practice
SN - 2666-6022
M1 - 100131
ER -
ID: 345681335