Journal of Clinical Medicine (Dec 2021)
Biomarkers Predict In-Hospital Major Adverse Cardiac Events in COVID-19 Patients: A Multicenter International Study
- Michael Y. Henein,
- Giulia Elena Mandoli,
- Maria Concetta Pastore,
- Nicolò Ghionzoli,
- Fouhad Hasson,
- Muhammad K. Nisar,
- Mohammed Islam,
- Francesco Bandera,
- Massimiliano M. Marrocco-Trischitta,
- Irene Baroni,
- Alessandro Malagoli,
- Luca Rossi,
- Andrea Biagi,
- Rodolfo Citro,
- Michele Ciccarelli,
- Angelo Silverio,
- Giulia Biagioni,
- Joseph A. Moutiris,
- Federico Vancheri,
- Giovanni Mazzola,
- Giulio Geraci,
- Liza Thomas,
- Mikhail Altman,
- John Pernow,
- Mona Ahmed,
- Ciro Santoro,
- Roberta Esposito,
- Guillem Casas,
- Rubén Fernández-Galera,
- Maribel Gonzalez,
- Jose Rodriguez Palomares,
- Ibadete Bytyçi,
- Frank Lloyd Dini,
- Paolo Cameli,
- Federico Franchi,
- Gani Bajraktari,
- Luigi Paolo Badano,
- Matteo Cameli
Affiliations
- Michael Y. Henein
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
- Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
- Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
- Nicolò Ghionzoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
- Fouhad Hasson
- Luton and Dunstable University Hospital, NHS Foundation Trust, Luton LU4 0DZ, UK
- Muhammad K. Nisar
- Luton and Dunstable University Hospital, NHS Foundation Trust, Luton LU4 0DZ, UK
- Mohammed Islam
- Luton and Dunstable University Hospital, NHS Foundation Trust, Luton LU4 0DZ, UK
- Francesco Bandera
- Department for Biomedical Sciences for Health, University of Milano, 20133 Milan, Italy
- Massimiliano M. Marrocco-Trischitta
- Clinical Research Unit, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
- Irene Baroni
- Clinical Research Unit, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
- Alessandro Malagoli
- Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, University of Modena and Reggio Emilia, 41126 Modena, Italy
- Luca Rossi
- Division of Cardiology, Cardiovascular and Emergency Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Andrea Biagi
- Division of Cardiology, Cardiovascular and Emergency Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Rodolfo Citro
- Cardio-Thoracic-Vascular Department, University Hospital San Giovanni di Dio e Ruggi d’Aragona, 84125 Salerno, Italy
- Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
- Angelo Silverio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
- Giulia Biagioni
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
- Joseph A. Moutiris
- Paphos Hospital, University of Nicosia, Nicosia 8100, Cyprus
- Federico Vancheri
- Department of Internal Medicine, S. Elia Hospital, 93100 Caltanissetta, Italy
- Giovanni Mazzola
- Department of Internal Medicine, S. Elia Hospital, 93100 Caltanissetta, Italy
- Giulio Geraci
- Department of Internal Medicine, S. Elia Hospital, 93100 Caltanissetta, Italy
- Liza Thomas
- Department of Cardiology, Westmead Hospital and Westmeead Clinical School, University of Sydney, Sydney, NSW 2145, Australia
- Mikhail Altman
- Department of Cardiology, Westmead Hospital and Westmeead Clinical School, University of Sydney, Sydney, NSW 2145, Australia
- John Pernow
- Department of Medicine, Division of Cardiology, Karolinska Institutet, 17177 Stockholm, Sweden
- Mona Ahmed
- Department of Molecular Medicine and Surgery, Division of Cardiology, Karolinska Institutet, 17177 Stockholm, Sweden
- Ciro Santoro
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
- Roberta Esposito
- Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy
- Guillem Casas
- Department of Cardiology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Rubén Fernández-Galera
- Department of Cardiology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Maribel Gonzalez
- Department of Cardiology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Jose Rodriguez Palomares
- Department of Cardiology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Ibadete Bytyçi
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
- Frank Lloyd Dini
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
- Paolo Cameli
- Respiratory Diseases Unit, Department of Medical Sciences, Siena University Hospital, 53100 Siena, Italy
- Federico Franchi
- Department of Medical Biotechnologies, Anesthesia and Intensive Care, University of Siena, 53100 Siena, Italy
- Gani Bajraktari
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
- Luigi Paolo Badano
- Istituto Auxologico Italiano, IRCCS, 20149 Milan, Italy
- Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
- DOI
- https://doi.org/10.3390/jcm10245863
- Journal volume & issue
-
Vol. 10,
no. 24
p. 5863
Abstract
Background: The COVID-19 pandemic carries a high burden of morbidity and mortality worldwide. We aimed to identify possible predictors of in-hospital major cardiovascular (CV) events in COVID-19. Methods: We retrospectively included patients hospitalized for COVID-19 from 10 centers. Clinical, biochemical, electrocardiographic, and imaging data at admission and medications were collected. Primary endpoint was a composite of in-hospital CV death, acute heart failure (AHF), acute myocarditis, arrhythmias, acute coronary syndromes (ACS), cardiocirculatory arrest, and pulmonary embolism (PE). Results: Of the 748 patients included, 141(19%) reached the set endpoint: 49 (7%) CV death, 15 (2%) acute myocarditis, 32 (4%) sustained-supraventricular or ventricular arrhythmias, 14 (2%) cardiocirculatory arrest, 8 (1%) ACS, 41 (5%) AHF, and 39 (5%) PE. Patients with CV events had higher age, body temperature, creatinine, high-sensitivity troponin, white blood cells, and platelet counts at admission and were more likely to have systemic hypertension, renal failure (creatinine ≥ 1.25 mg/dL), chronic obstructive pulmonary disease, atrial fibrillation, and cardiomyopathy. On univariate and multivariate analysis, troponin and renal failure were associated with the composite endpoint. Kaplan–Meier analysis showed a clear divergence of in-hospital composite event-free survival stratified according to median troponin value and the presence of renal failure (Log rank p < 0.001). Conclusions: Our findings, derived from a multicenter data collection study, suggest the routine use of biomarkers, such as cardiac troponin and serum creatinine, for in-hospital prediction of CV events in patients with COVID-19.
Keywords