Department of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Division of Cardiology, Azienda Sanitaria, Locale Torino 4, Ciriè, Italy.
Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland.
Int J Cardiol. 2022 Dec 15;369:48-53. doi: 10.1016/j.ijcard.2022.08.016. Epub 2022 Aug 6.
Myocardial injury (MINJ) is a well-recognized prognostic marker in different acute cardio-respiratory illnesses, nonetheless, its relevance in Influenza remains poorly defined. Our aim was to assess incidence, correlates, short and mid-term prognostic role of MINJ in Influenza.
Hospitalized patients (pts) with laboratory confirmed Influenza A or B underwent highly sensitive cardiac T Troponin (hs-cTnT) measurement at admission in four regional Swiss hospitals during the 2018-2019 epidemic. MINJ was defined as hs-cTnT >14 ng/L. Clinical, laboratory and outcome data were prospectively collected. The primary endpoint was mortality at 28 days while the composite of mortality, admission to intensive care unit (ICU) or need for mechanical ventilation at 28-days and mortality at 30-months were set as secondary endpoints.
The presence of MINJ was assessed within 48 h from admission in 145 consecutive hospitalized pts, being evident in 94 (65.5%) pts and associated with older age, higher C-reactive protein levels, renal impairment or chronic obstructive pulmonary disease. At a 28-days follow-up, 7 deaths (4.8%) occurred, all in patients with MINJ at admission (log-rank p = 0.048). MINJ was strongly associated with occurrence of death, ICU admission or mechanical ventilation (OR 5.74, 95% CI 1.28-53.29; p = 0.015). After a median follow-up of 32.7 months (IQR 32.2-33.4), 15 (10.3%) deaths occurred, all among pts with MINJ at index hospitalization leading to a higher mortality at follow-up among patients with MINJ (log-rank p = 0.003).
MINJ is common in patients hospitalized for Influenza and is able to stratify the risk of short-term adverse events and mid-term mortality.
心肌损伤（MINJ）是不同急性心肺疾病中公认的预后标志物，但在流感中的相关性仍未得到明确界定。我们的目的是评估流感患者 MINJ 的发生率、相关性、短期和中期预后作用。
在 2018-2019 年流感流行期间，瑞士四家地区医院的住院患者（pts）入院时接受实验室确诊的甲型或乙型流感的高敏心肌肌钙蛋白（hs-cTnT）检测。MINJ 的定义为 hs-cTnT＞14ng/L。前瞻性收集临床、实验室和结局数据。主要终点为 28 天死亡率，次要终点为 28 天死亡率、入住重症监护病房（ICU）或需要机械通气的复合终点以及 30 个月死亡率。
在 145 例连续住院患者中，在入院后 48 小时内评估了 MINJ 的存在，94 例（65.5%）患者存在 MINJ，MINJ 与年龄较大、C 反应蛋白水平较高、肾功能损害或慢性阻塞性肺疾病相关。在 28 天随访中，7 例（4.8%）死亡，均发生在入院时存在 MINJ 的患者中（log-rank p=0.048）。MINJ 与死亡、入住 ICU 或机械通气的发生密切相关（OR 5.74，95%CI 1.28-53.29；p=0.015）。中位随访 32.7 个月（IQR 32.2-33.4）后，15 例（10.3%）死亡，均发生在入院时存在 MINJ 的患者中，导致随访期间存在 MINJ 的患者死亡率更高（log-rank p=0.003）。
MINJ 在因流感住院的患者中很常见，能够对短期不良事件和中期死亡率的风险进行分层。
