The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60-11.03]P<0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50-7.47]P<0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33-7.09]P<0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18-6.36]P<0.001), and CK was 3.56 ([95% CI, 2.53-5.02]P<0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 19%-50% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19-associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.
第一作者机构:[1]Wuhan Univ, Zhongnan Hosp, Dept Cardiol, Wuhan, Peoples R China[5]Wuhan Univ, Dept Cardiol, Renmin Hosp, Wuhan, Peoples R China[7]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[2]Wuhan Univ, Zhongnan Hosp, Med Sci Res Ctr, Wuhan, Peoples R China[4]Wuhan Univ, Basic Med Sch, Wuhan, Peoples R China[5]Wuhan Univ, Dept Cardiol, Renmin Hosp, Wuhan, Peoples R China[7]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China[8]Univ Ottawa Heart Inst, Dept Med, Div Cardiol, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada[13]Univ Calif Los Angeles, David Geffen Sch Med, Dept Anesthesiol, Cardiovasc Res Labs, Los Angeles, CA 90095 USA[*1]Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario K1Y 4W7, Canada[*2]Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, CA[*3]Department of Cardiology, Zhongnan Hospital of Wuhan University, Institute of Model Animal of Wuhan University, 169 Donghu Rd, Wuhan 430071, China
推荐引用方式(GB/T 7714):
Qin Juan-Juan,Cheng Xu,Zhou Feng,et al.Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19[J].HYPERTENSION.2020,76(4):1104-1112.doi:10.1161/HYPERTENSIONAHA.120.15528.
APA:
Qin, Juan-Juan,Cheng, Xu,Zhou, Feng,Lei, Fang,Akolkar, Gauri...&Li, Hongliang.(2020).Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19.HYPERTENSION,76,(4)
MLA:
Qin, Juan-Juan,et al."Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19".HYPERTENSION 76..4(2020):1104-1112