Department of Internal Medicine III, Cardiology, University of Heidelberg, Heidelberg, Germany.
Department Internal Medicine I, Endocrinology, University of Heidelberg, Heidelberg, Germany.
Biomarkers. 2021 Jul;26(5):401-409. doi: 10.1080/1354750X.2021.1921031. Epub 2021 May 24.
Application of the 4th version of Universal Definition of Myocardial Infarction (UDMI) to characterize rates and prognostic relevance of myocardial injury in COVID-19 disease.
This retrospective, single-centre observational study enrolled 104 patients hospitalized with SARS-CoV-2 infection. Kaplan-Meier analysis and multivariate Cox regression were used to identify influence of acute or chronic myocardial injury on a composite primary (mortality, incident acute respiratory distress syndrome, incident mechanical ventilation) and secondary endpoint (mortality, incident acute myocardial injury during hospitalization, incident venous thrombosis, pulmonary embolism or stroke).
A total of 27 (26.0%) patients presented with chronic myocardial injury, and 19 (18.3%) with acute myocardial injury. 42 patients(40.4%) developed an incident myocardial injury during hospitalization. The presence of acute or chronic myocardial injury on admission and incident myocardial injury during hospitalization were associated with higher rates of endpoints. Independent predictors for the primary endpoint were higher severity stages according to Siddiqi classification system and history of dyslipidaemia. Maximal hs-cTnT and D-dimer concentrations during hospitalization showed an association ( = 0.61).
Objective description of myocardial injury according to the 4th UDMI in the current COVID-19 pandemic is crucial in order to discriminate patients with acute myocardial infarction and acute, chronic or incident myocardial injury.
应用第四版通用心肌梗死定义（UDMI）来描述 COVID-19 疾病中心肌损伤的发生率和预后相关性。
这是一项回顾性、单中心观察性研究，共纳入 104 例因 SARS-CoV-2 感染住院的患者。采用 Kaplan-Meier 分析和多变量 Cox 回归分析，确定急性或慢性心肌损伤对复合主要终点（死亡率、新发急性呼吸窘迫综合征、新发机械通气）和次要终点（住院期间死亡率、新发急性心肌损伤、静脉血栓形成、肺栓塞或中风）的影响。
共有 27 例（26.0%）患者存在慢性心肌损伤，19 例（18.3%）患者存在急性心肌损伤。42 例（40.4%）患者在住院期间发生新发心肌损伤。入院时存在急性或慢性心肌损伤以及住院期间新发心肌损伤与终点发生率较高有关。根据 Siddiqi 分类系统的严重程度较高和血脂异常史是主要终点的独立预测因素。住院期间 hs-cTnT 和 D-二聚体的最大浓度呈正相关（ = 0.61）。
在当前 COVID-19 大流行中，根据第四版 UDMI 对心肌损伤进行客观描述，对于区分急性心肌梗死、急性、慢性或新发心肌损伤患者至关重要。
