Perrone Marco Alfonso, Spolaore Federica, Ammirabile Massimiliano, Romeo Francesco, Caciagli Patrizio, Ceriotti Ferruccio, Bernardini Sergio
Division of Cardiology, University of Rome Tor Vergata, Rome, Italy.
Division of Clinical Biochemistry and Clinical Molecular Biology, University of Rome Tor Vergata, Rome, Italy.
Int J Cardiol Heart Vasc. 2021 Feb;32:100715. doi: 10.1016/j.ijcha.2021.100715. Epub 2021 Jan 9.
Recent studies have shown that patients diagnosed with coronarivus disease 2019 (COVID-19) and also with previous cardiovascular diseases have a higher mortality due to worsening heart disease. At the same time, patients without previous cardiovascular disease may also have cardiac complications. The aim of this multicenter study was to assess high sensitivity cardiac troponin T (hs-cTnT) in patients with COVID-19 and to evaluate the incidence of myocardial injury.
In this multicenter study we enrolled 543 patients, 57.8% males, median age 63 years (range 18-99) from three selected hospitals: University Hospital Tor Vergata in Rome, Fondazione IRCCS Ca 'Granda Ospedale Maggiore Policlinico, in Milan, S Chiara Hospital in Trento. We measured hs-cTnT in all patients to assess myocardial injury and correlations with patient's age, symptoms and disease course.
The data showed that, among the 543 patients studied, 257 patients (47.3%) had hs-cTnT values higher than the upper reference limit (URL) of 14 ng/L. Patients with high hs-cTnT had more frequently fever (p < 0.01) and respiratory symptoms (p < 0.01), compared to the group with hs-cTnT values below URL. The results showed also that patients with hs-cTnT above URL had a higher frequency of previous cardiovascular disease (p < 0.01) as well as of hypertension (p < 0.01). Instead, among 231 patients with no previous cardiovascular disease, 81 (31.5%) had hs-cTnT values above the URL. Finally. the majority of the patients with high hs-cTnT were admitted to the intensive care unit (p < 0.01).
Our data suggest the assessment of high sensitivity cardiac troponin in patients with COVID-19 for early diagnosis of cardiac involvement.
最近的研究表明，被诊断患有2019冠状病毒病（COVID-19）且既往有心血管疾病的患者，由于心脏病恶化，死亡率更高。同时，既往无心血管疾病的患者也可能出现心脏并发症。这项多中心研究的目的是评估COVID-19患者的高敏心肌肌钙蛋白T（hs-cTnT），并评估心肌损伤的发生率。
在这项多中心研究中，我们从三家选定的医院招募了543名患者，男性占57.8%，中位年龄63岁（范围18-99岁）：罗马的托尔韦尔加塔大学医院、米兰的圣拉斐尔科学研究所马焦雷综合医院基金会以及特伦托的圣基亚拉医院。我们测量了所有患者的hs-cTnT，以评估心肌损伤及其与患者年龄、症状和病程的相关性。
数据显示，在研究的543名患者中，257名患者（47.3%）的hs-cTnT值高于14 ng/L的上限参考值（URL）。与hs-cTnT值低于URL的组相比，hs-cTnT值高的患者发热（p < 0.01）和呼吸道症状（p < 0.01）更为常见。结果还表明，hs-cTnT高于URL的患者既往有心血管疾病（p < 0.01）以及高血压（p < 0.01）的频率更高。相反，在231名既往无心血管疾病的患者中，81名（31.5%）的hs-cTnT值高于URL。最后，大多数hs-cTnT值高的患者被收入重症监护病房（p < 0.01）。
我们的数据表明，对COVID-19患者进行高敏心肌肌钙蛋白评估有助于早期诊断心脏受累情况。
