Troponin T in COVID-19 hospitalized patients: Kinetics matter

• Published in: Cardiology journal 2021, Vol.28 (6), p.807-815
• Main Authors: Luchian, Maria-Luiza, Motoc, Andreea Iulia, Lochy, Stijn, Magne, Julien, Roosens, Bram, Belsack, Dries, Van den Bussche, Karen, von Kemp, Berlinde, Galloo, Xavier, François, Clara, Scheirlynck, Esther, Boeckstaens, Sven, De Potter, Tom, Seyler, Lucie, van Laethem, Johan, Hennebicq, Sophie, Weytjens, Caroline, Droogmans, Steven, Cosyns, Bernard
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomarkers - blood; Coronaviruses; COVID-19; COVID-19 - diagnosis; Female; Humans; Kinetics; Male; Middle Aged; Mortality; Proportional Hazards Models; Troponin T - blood
• ISSN: 1897-5593; 1898-018X
• DOI: 10.5603/CJ.a2021.0104

Coronavirus disease 2019 (COVID-19) emerged as a worldwide health crisis, overwhelming healthcare systems. Elevated cardiac troponin T (cTn T) at admission was associated with increased in-hospital mortality. However, data addressing the role of cTn T in major adverse cardiovascular events (MACE) in COVID-19 are scarce. Therefore, we assessed the role of baseline cTn T and cTn T kinetics for MACE and in-hospital mortality prediction in COVID-19. Three hundred and ten patients were included prospectively. One hundred and eight patients were excluded due to incomplete records. Patients were divided into three groups according to cTn T kinetics: ascending, descending, and constant. The cTn T slope was defined as the ratio of the cTn T change over time. The primary and secondary endpoints were MACE and in-hospital mortality. Two hundred and two patients were included in the analysis (mean age 64.4 ± 16.7 years, 119 [58.9%] males). Mean duration of hospitalization was 14.0 ± 12.3 days. Sixty (29.7%) patients had MACE, and 40 (19.8%) patients died. Baseline cTn T predicted both endpoints (p = 0.047, hazard ratio [HR] 1.805, 95% confidence interval [CI] 1.009-3.231; p = 0.009, HR 2.322, 95% CI 1.234-4.369). Increased cTn T slope predicted mortality (p = 0.041, HR 1.006, 95% CI 1.000-1.011). Constant cTn T was associated with lower MACE and mortality (p = 0.000, HR 3.080, 95% CI 1.914-4.954, p = 0.000, HR 2.851, 95% CI 1.828-4.447). The present study emphasizes the additional role of cTn T testing in COVID-19 patients for risk stratification and improved diagnostic pathway and management.