First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland.
First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
Pol Arch Intern Med. 2022 Aug 22;132(7-8). doi: 10.20452/pamw.16256. Epub 2022 May 6.
High‑sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B type natriuretic peptide (NT‑ proBNP) are known markers of cardiac injury. However, their role in predicting the severity of COVID‑19 remains to be investigated.
We aimed to analyze the association between hs‑cTnT and NT-proBNP levels and in hospital mortality in patients with COVID‑19, with emphasis on those with concomitant chronic heart failure (CHF).
A total of 1729 consecutive patients with COVID‑19 were enrolled. Demographic data, laboratory parameters, and clinical outcomes (discharge or death) were analyzed. Receiver operating characteristic (ROC) and logistic regression analyses were performed to evaluate the association between hs‑cTnT and NT-proBNP values and the risk of death.
Evaluation of hs‑cTnT was performed in 1041 patients, while NT-proBNP was assessed in 715 individuals. CHF was present in 179 cases (10.4% of the cohort). Median values of hs‑cTnT and NT-proBNP and in‑hospital mortality were higher in CHF patients than in those without CHF. Among patients without CHF, mortality was the highest in those with hs‑cTnT or NT-proBNP values in the fourth quartile. In ROC analysis, hs‑cTnT equal to or above 142 ng/l and NT-proBNP equal to or above 969 pg/ml predicted in‑hospital death. In patients without CHF, each 10-ng/l increase in hs-cTnT or 100-pg/ml increase in NT‑proBNP was associated with a higher risk of death (odds ratio [OR], 1.01 and OR, 1.02, respectively; P <0.01 for both).
The level of hs‑cTnT or NT-proBNP predicts in hospital mortality in COVID-19 patients. Both hs‑cTnT and NT-proBNP should be routinely measured on admission in all patients hospitalized due to COVID‑19 for early detection of individuals with an increased risk of in hospital death, even if they do not have concomitant heart failure.
高敏心肌肌钙蛋白 T（hs-cTnT）和 N 末端脑利钠肽前体（NT-proBNP）是已知的心肌损伤标志物。然而，它们在预测 COVID-19 严重程度方面的作用仍有待研究。
我们旨在分析 hs-cTnT 和 NT-proBNP 水平与 COVID-19 患者住院期间死亡率之间的关系，并特别关注伴有合并慢性心力衰竭（CHF）的患者。
共纳入 1729 例连续的 COVID-19 患者。分析了患者的人口统计学数据、实验室参数和临床结局（出院或死亡）。进行了受试者工作特征（ROC）和逻辑回归分析，以评估 hs-cTnT 和 NT-proBNP 值与死亡风险之间的关系。
对 1041 例患者进行了 hs-cTnT 评估，对 715 例患者进行了 NT-proBNP 评估。该队列中 179 例（10.4%）存在 CHF。与无 CHF 的患者相比，hs-cTnT 和 NT-proBNP 值以及住院死亡率在 CHF 患者中更高。在无 CHF 的患者中，hs-cTnT 或 NT-proBNP 值处于第四四分位数的患者死亡率最高。在 ROC 分析中，hs-cTnT 等于或高于 142ng/L 和 NT-proBNP 等于或高于 969pg/ml 预测住院死亡。在无 CHF 的患者中，hs-cTnT 每增加 10ng/L 或 NT-proBNP 增加 100pg/ml，死亡风险就会增加（比值比[OR]分别为 1.01 和 1.02；均 P<0.01）。
hs-cTnT 或 NT-proBNP 水平可预测 COVID-19 患者的住院死亡率。在因 COVID-19 住院的所有患者中，应常规在入院时测量 hs-cTnT 和 NT-proBNP，以便早期发现死亡风险增加的患者，即使他们没有合并心力衰竭。
