Troponin T in COVID-19 hospitalized patients: Kinetics matter

Maria-Luiza Luchian (1, 2) , Andreea Iulia Motoc (1, 2) , Stijn Lochy (2, 1) , Julien Magne (3, 4) , Bram Roosens (2, 1) , Dries Belsack (1, 2) , Karen van den Bussche (1, 2) , Berlinde von Kemp (1, 2) , Xavier Galloo (1, 2) , Clara François (1, 2) , Esther Scheirlynck (1, 2) , Sven Boeckstaens (1, 2) , Tom de Potter (1) , Lucie Seyler (1) , Johan van Laethem (1, 2) , Sophie Hennebicq , Caroline Weytjens (2, 1) , Steven Droogmans (2, 1) , Bernard Cosyns (2, 1)

1 VUB - Vrije Universiteit Brussel [Bruxelles]
2 Universitair Ziekenhuis [Brussels, Belgium]
3 NET - Neuroépidémiologie Tropicale
4 Service de cardiologie [CHU Limoges]

Background: 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. Methods: 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. Results: 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). Conclusions: The present study emphasizes the additional role of cTn T testing in COVID-19 patients for risk stratification and improved diagnostic pathway and management.

Mots clés: COVID-19; cardiac troponin; kinetics; major cardiovascular adverse events; mortality; myocardial injury

Domaines: Santé publique et épidémiologie

Maria-Luiza Luchian, Andreea Iulia Motoc, Stijn Lochy, Julien Magne, Bram Roosens, et al.. Troponin T in COVID-19 hospitalized patients: Kinetics matter. Cardiology journal, 2021, ⟨10.5603/CJ.a2021.0104⟩. ⟨hal-03456917⟩