Background: Although studies assessing cardiovascular comorbidities and myocardial injury in Coronavirus disease 2019 (COVID-19) patients have been published, no reports focused on clinical outcomes of myocardial injury in patients with and without chronic coronary syndromes (CCS) are currently available. Methods: In this study, consecutive COVID-19 patients admitted to four different institutions were screened for enrolment. Patients were divided into two groups (CCS vs. no-CCS). Association with in-hospital mortality and related predictors represented the main study outcome; myocardial injury and its predictors were deemed secondary outcomes. Results: A total of 674 COVID-19 patients were enrolled, 112 (16.6%) with an established history of CCS. Myocardial injury occurred in 43.8% patients with CCS vs. 14.4% patients without CCS, as confirmed by high-sensitivity cardiac troponin (hs-cTn) elevation on admission or during hospitalization. The mortality rate in the CCS cohort was nearly three-fold higher. After adjusting for disease severity, myocardial injury resulted significantly associated with in-hospital mortality in the no-CCS group but not in CCS patients. Conclusions: Patients with CCS and COVID-19 showed high mortality rate. Myocardial injury may be a bystander in CCS patients and COVID-19, while in patients without known history of CCS, myocardial injury has a significant role in predicting poor outcomes.

Redefining the Prognostic Value of High-Sensitivity Troponin in COVID-19 Patients: The Importance of Concomitant Coronary Artery Disease / M. Schiavone, A. Gasperetti, M. Mancone, A.V. Kaplan, C. Gobbi, G. Mascioli, M. Busana, A.M. Saguner, G. Mitacchione, A. Giacomelli, G. Sardella, M. Viecca, F. Duru, S. Antinori, S. Carugo, A.L. Bartorelli, C. Tondo, M. Galli, F. Fedele, G.B. Forleo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 9:10(2020 Oct). [10.3390/jcm9103263]

Redefining the Prognostic Value of High-Sensitivity Troponin in COVID-19 Patients: The Importance of Concomitant Coronary Artery Disease

M. Schiavone
Primo
;
A. Gasperetti
Secondo
;
C. Gobbi;M. Busana;A. Giacomelli;S. Antinori;S. Carugo;A.L. Bartorelli;C. Tondo;M. Galli;
2020

Abstract

Background: Although studies assessing cardiovascular comorbidities and myocardial injury in Coronavirus disease 2019 (COVID-19) patients have been published, no reports focused on clinical outcomes of myocardial injury in patients with and without chronic coronary syndromes (CCS) are currently available. Methods: In this study, consecutive COVID-19 patients admitted to four different institutions were screened for enrolment. Patients were divided into two groups (CCS vs. no-CCS). Association with in-hospital mortality and related predictors represented the main study outcome; myocardial injury and its predictors were deemed secondary outcomes. Results: A total of 674 COVID-19 patients were enrolled, 112 (16.6%) with an established history of CCS. Myocardial injury occurred in 43.8% patients with CCS vs. 14.4% patients without CCS, as confirmed by high-sensitivity cardiac troponin (hs-cTn) elevation on admission or during hospitalization. The mortality rate in the CCS cohort was nearly three-fold higher. After adjusting for disease severity, myocardial injury resulted significantly associated with in-hospital mortality in the no-CCS group but not in CCS patients. Conclusions: Patients with CCS and COVID-19 showed high mortality rate. Myocardial injury may be a bystander in CCS patients and COVID-19, while in patients without known history of CCS, myocardial injury has a significant role in predicting poor outcomes.
COVID-19; cardiac troponin; chronic coronary syndromes; coronary artery disease; myocardial injury
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
ott-2020
Article (author)
File in questo prodotto:
File Dimensione Formato  
2020 J clinical med.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 439.19 kB
Formato Adobe PDF
439.19 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/772398
Citazioni
  • ???jsp.display-item.citation.pmc??? 24
  • Scopus 30
  • ???jsp.display-item.citation.isi??? 31
social impact