Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study
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. Metho...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-02-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602222000489 |
| _version_ | 1828347599248162816 |
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| author | Christoffer Polcwiartek Maria L. Krogager Mikkel P. Andersen Jawad H. Butt Jannik Pallisgaard Emil Fosbøl Morten Schou Deepak L. Bhatt Avinainder Singh Lars Køber Gunnar H. Gislason Casper N. Bang Christian Torp-Pedersen Kristian Kragholm Manan Pareek |
| author_facet | Christoffer Polcwiartek Maria L. Krogager Mikkel P. Andersen Jawad H. Butt Jannik Pallisgaard Emil Fosbøl Morten Schou Deepak L. Bhatt Avinainder Singh Lars Køber Gunnar H. Gislason Casper N. Bang Christian Torp-Pedersen Kristian Kragholm Manan Pareek |
| author_sort | Christoffer Polcwiartek |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-14T00:42:44Z |
| format | Article |
| id | doaj.art-ba62c4c0ff504092ab7c8d824f412f67 |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-14T00:42:44Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-ba62c4c0ff504092ab7c8d824f412f672022-12-22T02:22:09ZengElsevierAmerican Heart Journal Plus2666-60222022-02-0114100131Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort studyChristoffer Polcwiartek0Maria L. Krogager1Mikkel P. Andersen2Jawad H. Butt3Jannik Pallisgaard4Emil Fosbøl5Morten Schou6Deepak L. Bhatt7Avinainder Singh8Lars Køber9Gunnar H. Gislason10Casper N. Bang11Christian Torp-Pedersen12Kristian Kragholm13Manan Pareek14Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, DenmarkDepartment of Cardiology, Aalborg University Hospital, Aalborg, DenmarkDepartment of Clinical Research and Cardiology, Nordsjællands Hospital, Hillerød, DenmarkThe Heart Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, Herlev and Gentofte Hospital, Copenhagen, DenmarkThe Heart Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, Herlev and Gentofte Hospital, Copenhagen, DenmarkBrigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA, USABrigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA, USA; Department of Internal Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USAThe Heart Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, Herlev and Gentofte Hospital, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, DenmarkDepartment of Cardiology, Frederiksberg and Bispebjerg Hospital, Copenhagen, DenmarkDepartment of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Research and Cardiology, Nordsjællands Hospital, Hillerød, DenmarkDepartment of Cardiology, Aalborg University Hospital, Aalborg, DenmarkDepartment of Clinical Research and Cardiology, Nordsjællands Hospital, Hillerød, Denmark; Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen, Denmark; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA, USA; Department of Internal Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USA; Corresponding author at: Department of Cardiology, Herlev and Gentofte Hospital, Gentofte Hospitalsvej 4, 2900 Hellerup, Denmark.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.http://www.sciencedirect.com/science/article/pii/S2666602222000489Coronavirus disease 2019Myocardial injuryTroponin TTroponin IOutcomes |
| spellingShingle | Christoffer Polcwiartek Maria L. Krogager Mikkel P. Andersen Jawad H. Butt Jannik Pallisgaard Emil Fosbøl Morten Schou Deepak L. Bhatt Avinainder Singh Lars Køber Gunnar H. Gislason Casper N. Bang Christian Torp-Pedersen Kristian Kragholm Manan Pareek Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study American Heart Journal Plus Coronavirus disease 2019 Myocardial injury Troponin T Troponin I Outcomes |
| title | Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study |
| title_full | Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study |
| title_fullStr | Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study |
| title_full_unstemmed | Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study |
| title_short | Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study |
| title_sort | prognostic implications of serial high sensitivity cardiac troponin testing among patients with covid 19 a danish nationwide registry based cohort study |
| topic | Coronavirus disease 2019 Myocardial injury Troponin T Troponin I Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666602222000489 |
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