The following article is a part of conference coverage from the American College of Cardiology’s 70th Annual Scientific Session & Expo is being held virtually from May 15 to 17, 2021. The team at Cardiology Advisor will be reporting on the latest news and research conducted by clinicians and scientists in the field. Check back for more from the ACC 2021 .
Elevated serum troponin-I levels among patients admitted to the hospital with COVID-19 are linked to an increased likelihood of poorer clinical outcomes and in-hospital mortality. These findings were presented during the American College of Cardiology Annual Meeting, held virtually from May 15 to 17, 2021.
Patients (N=416) who tested positive for SARS-CoV-2 infection and were assessed for troponin-I within 48 hours of admission to a large public hospital in Cook County, Illinois were retrospectively reviewed for clinical outcomes. Patients with end-stage renal disease or chronic kidney disease were excluded from this analysis due to the potential for elevated troponin-I associated with renal clearance impairment.
Most patients (53.5%) underwent troponin-I assessment within 24 hours of hospital admission. Troponin-I was >3 times the upper limit of normal among 44.2% of patients.
A >3 times upper limit of normal troponin-I status associated with increased risk for requiring mechanical ventilation (adjusted odds ratio [aOR], 33.5; 95% CI, 9.4-119.8), receiving hemodynamic support (aOR, 71.4; 95% CI, 15.7-324.6), transfer to the intensive care unit (aOR, 18.2; 95% CI, 4.7-70.4), and in-hospital mortality (aOR, 12.1; 95% CI, 3.8-38.3).
Elevated troponin-I was more likely among all patients with hypertension (aOR, 2.33; 95% CI, 1.01-5.38) and among patients treated in the standard care unit who had chronic heart failure (aOR, 4.83; 95% CI, 1.05-22.16).
The investigators observed similar patterns among all ethnic subgroups.
These findings were based on data from a single large public hospital and should be replicated in other care settings.
The study authors concluded that patients admitted to the hospital for COVID-19 who have elevated troponin-I, especially above 3 times the upper limit of normal, were more likely to have poorer clinical outcomes, to increase healthcare burden, and to die during hospitalization. In addition, patients with hypertension or chronic heart failure were more likely to present with elevated troponin-I.
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Quelal K, Torres A, Masri A, Golzar Y. Troponin Elevation as a Predictor for Outcomes of Patients Diagnosed With COVID-19 Infection in a Large Public Hospital in the Chicago Area. Presented at: ACC.21 annual Meeting May 15-17, 2021.