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[肌钙蛋白-T和N末端脑钠肽前体血浆水平及其与新型冠状病毒肺炎死亡率的关系]

[Troponin-T and n-terminal pro-brain type natriuretic peptide plasma levels and its relationship with mortality in COVID-19].

作者信息

Ghelfi A M, Sánchez B A, Berbotto L A, Dipaolo F R, Bosque V, Velez L L, Cordone M A, Pallero R N, Yiguerimian L M, Kilstein J G

机构信息

Hospital Escuela Eva Perón, Granadero Baigorria, Santa Fe, Argentina.

Hospital Escuela Eva Perón, Granadero Baigorria, Santa Fe, Argentina.

出版信息

Hipertens Riesgo Vasc. 2022 Jul-Sep;39(3):105-113. doi: 10.1016/j.hipert.2022.03.002. Epub 2022 Apr 28.

Abstract

INTRODUCTION

Cardiovascular compromise in coronavirus disease 2019 (COVID-19) does not necessarily present with the classic symptoms described in myocarditis. There is growing evidence demonstrating subclinical cardiovascular compromise in the context of the intense inflammation unleashed, the cytokine storm involved, the baseline prothrombotic state, and the consequent endothelial dysfunction. We set out to analyse whether Troponin-T (TT) and the amino-terminal fraction of pro-brain natriuretic peptide (NT-proBNP) determined at hospital admission, are related to mortality during the hospitalization of these patients.

MATERIAL AND METHODS

Analytical, observational, retrospective cohort and cross-sectional study. It included subjects with COVID-19 hospitalized for moderate-severe illness, from 20/03/20 to 15/11/20. The TT and NT-proBNP obtained in the first 24 hours from admission were analysed. Altered TT was considered if ≥.014 ng/dl and altered NT-proBNP if ≥300 pg/ml.

RESULTS

One hundred and eight subjects were included, 63.2% men, age 51.5 years (59-43), 28% were admitted to the Critical Unit and 25% died. The group with elevated TT presented higher mortality (OR = 3.1; 95%CI = 1.10-8.85; p = .02). The group with elevated NT-proBNP also show higher mortality (OR = 3.47; 95%CI = 1.21-9.97; p = .01). On multivariate analysis, only NT-proBNP ≥300 pg/ml remained an independent risk factor.

CONCLUSIONS

NT-proBNP levels ≥300 pg/ml at admission in patients with moderate-severe COVID-19 were associated with higher mortality.

摘要

引言

2019年冠状病毒病(COVID-19)中的心血管功能损害不一定表现为心肌炎中描述的典型症状。越来越多的证据表明,在强烈炎症反应、细胞因子风暴、基线血栓前状态以及随之而来的内皮功能障碍的背景下,存在亚临床心血管功能损害。我们旨在分析入院时测定的肌钙蛋白T(TT)和脑钠肽前体氨基末端片段(NT-proBNP)是否与这些患者住院期间的死亡率相关。

材料与方法

分析性、观察性、回顾性队列和横断面研究。研究对象为2020年3月20日至11月15日因中重度疾病住院的COVID-19患者。分析入院后最初24小时内获得的TT和NT-proBNP。若TT≥0.014 ng/dl,则认为TT异常;若NT-proBNP≥300 pg/ml,则认为NT-proBNP异常。

结果

共纳入108名受试者,男性占63.2%,年龄51.5岁(59 - 43岁),28%入住重症监护病房,25%死亡。TT升高组的死亡率更高(OR = 3.1;95%CI = 1.10 - 8.85;p = 0.02)。NT-proBNP升高组的死亡率也更高(OR = 3.47;95%CI = 1.21 - 9.97;p = 0.01)。多因素分析显示,只有NT-proBNP≥300 pg/ml仍然是一个独立的危险因素。

结论

中重度COVID-19患者入院时NT-proBNP水平≥300 pg/ml与较高的死亡率相关。

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