Troponin levels may be affected by beta natriuretic peptide (BNP), interleukin (IL)-6, and D-dimer concentrations among patients with COVID-19. These findings were presented during the American College of Cardiology Annual Meeting, held virtually from May 15 to 17, 2021.
Patients with severe COVID-19 are at risk for having a hyperinflammatory response such as a cytokine storm. Recent data suggest that some patients with COVID-19 experience cardiovascular damage. It remains unclear whether troponin levels during the course of a SARS-CoV-2 infection may be affected by markers of inflammation.
To assess the relationship of COVID-19 and troponin, patients (N=586) admitted to Hackensack University Medical Center in New Jersey between February and June of 2020 who underwent at least 2 troponin assessments were retrospectively reviewed for hyperinflammatory responses and clinical outcomes.
Mortality was associated with age, hypertension, coronary artery disease, heart failure, previous percutaneous cardiac intervention, use of beta blockers or statins, hemodialysis, shock, concentrations of C-reactive protein, concentrations of IL-6, and change in troponin levels (all P <.05).
Maximum troponin level correlated with BNP (r, 0.55; P <.05), D-dimer (r, 0.42; P <.05), and IL-6 (r, 0.30; P <.05) concentrations. Baseline troponin level was also correlated with BNP (r, 0.54; P <.05), D-dimer (r, 0.43; P <.05), and creatinine (r, 0.43; P <.05) concentrations.
This study was limited by its retrospective design because there had been no predetermined protocol for assessing troponin at set timepoints during patient hospitalization.
These findings suggest the hyperinflammatory response may contribute to troponin perturbation over the disease course of COVID-19. The response to increased inflammation associated with severe SARS-CoV-2 infections may contribute to multiorgan dysfunction and lead to long-term sequelae.
Additional studies of troponin levels among patients hospitalized with COVID-19 are needed to assess whether reductions in the inflammatory response may decrease troponin levels and subsequent cardiac injury.
Klinkhammer B, Go R, Hollenberg S, et al. Troponin correlates with inflammatory markers in COVID-19. Presented at: American College of Cardiology Annual Meeting; May 15-17, 2021. Presentation: 1088-11.