BACKGROUND Increases in cardiac troponin(cTn)in coronavirus disease 2019(COVID19)have been associated with worse prognosis.Nonetheless,data about the significance of cTn in elderly subjects with COVID19 are lacking.ME...BACKGROUND Increases in cardiac troponin(cTn)in coronavirus disease 2019(COVID19)have been associated with worse prognosis.Nonetheless,data about the significance of cTn in elderly subjects with COVID19 are lacking.METHODS From a registry of consecutive patients with COVID19 admitted to a hub hospital in Italy from 25/02/2020 to 03/07/2020,we selected those≥60 yearold and with cTnI measured within three days from the molecular diagnosis of SARSCoV2 infection.When available,a second cTnI value within 48 h was also extracted.The relationship between increased cTnI and allcause inhospital mortality was evaluated by a Cox regression model and restricted cubic spline functions with three knots.RESULTS Of 343 included patients(median age:75.0(68.0−83.0)years,34.7%men),88(25.7%)had cTnI above the upperreference limit(0.046μg/L).Patients with increased cTnI had more comorbidities,greater impaired respiratory exchange and higher inflammatory markers on admission than those with normal cTnI.Furthermore,they died more(73.9%vs.37.3%,P<0.001)over 15(6−25)days of hospitalization.The association of elevated cTnI with mortality was confirmed by the adjusted Cox regression model(HR=1.61,95%CI:1.06−2.52,P=0.039)and was linear until 0.3μg/L,with a subsequent plateau.Of 191(55.7%)patients with a second cTnI measurement,49(25.7%)had an increasing trend,which was not associated with mortality(univariate HR=1.39,95%CI:0.87−2.22,P=0.265).CONCLUSIONS In elderly COVID19 patients,an initial increase in cTn is common and predicts a higher risk of death.Serial cTn testing may not confer additional prognostic information.展开更多
文摘BACKGROUND Increases in cardiac troponin(cTn)in coronavirus disease 2019(COVID19)have been associated with worse prognosis.Nonetheless,data about the significance of cTn in elderly subjects with COVID19 are lacking.METHODS From a registry of consecutive patients with COVID19 admitted to a hub hospital in Italy from 25/02/2020 to 03/07/2020,we selected those≥60 yearold and with cTnI measured within three days from the molecular diagnosis of SARSCoV2 infection.When available,a second cTnI value within 48 h was also extracted.The relationship between increased cTnI and allcause inhospital mortality was evaluated by a Cox regression model and restricted cubic spline functions with three knots.RESULTS Of 343 included patients(median age:75.0(68.0−83.0)years,34.7%men),88(25.7%)had cTnI above the upperreference limit(0.046μg/L).Patients with increased cTnI had more comorbidities,greater impaired respiratory exchange and higher inflammatory markers on admission than those with normal cTnI.Furthermore,they died more(73.9%vs.37.3%,P<0.001)over 15(6−25)days of hospitalization.The association of elevated cTnI with mortality was confirmed by the adjusted Cox regression model(HR=1.61,95%CI:1.06−2.52,P=0.039)and was linear until 0.3μg/L,with a subsequent plateau.Of 191(55.7%)patients with a second cTnI measurement,49(25.7%)had an increasing trend,which was not associated with mortality(univariate HR=1.39,95%CI:0.87−2.22,P=0.265).CONCLUSIONS In elderly COVID19 patients,an initial increase in cTn is common and predicts a higher risk of death.Serial cTn testing may not confer additional prognostic information.
