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Multicenter Study
. 2021 Aug 1;32(5):359-366.
doi: 10.1097/MCA.0000000000000914.

Prognostic significance of cardiac injury in COVID-19 patients with and without coronary artery disease

Hasan Ali Barman  1 , Adem Atici  2 , Irfan Sahin  3 , Gokhan Alici  1 , Esra Aktas Tekin  4 , Ömer Faruk Baycan  2 , Fatih Ozturk  5 , Ersan Oflar  6 , Sevil Tugrul  3 , Mustafa Baran Yavuz  3 , Fatma Betul Celik  2 , Aysu Oktay  2 , Haluk Vahaboglu  7 , Mine Adas  8 , Namigar Turgut  4 , Ertugrul Okuyan  3 , Mustafa Taner Yildirmak  9 , Baris Gungor  10
Affiliations
Multicenter Study

Prognostic significance of cardiac injury in COVID-19 patients with and without coronary artery disease

Hasan Ali Barman et al. Coron Artery Dis. .

Abstract

Objective: COVID-19 is a disease with high mortality, and risk factors for worse clinical outcome have not been well-defined yet. The aim of this study is to delineate the prognostic importance of presence of concomitant cardiac injury on admission in patients with COVID-19.

Methods: For this multi-center retrospective study, data of consecutive patients who were treated for COVID-19 between 20 March and 20 April 2020 were collected. Clinical characteristics, laboratory findings and outcomes data were obtained from electronic medical records. In-hospital clinical outcome was compared between patients with and without cardiac injury.

Results: A total of 607 hospitalized patients with COVID-19 were included in the study; the median age was 62.5 ± 14.3 years, and 334 (55%) were male. Cardiac injury was detected in 150 (24.7%) of patients included in the study. Mortality rate was higher in patients with cardiac injury (42% vs. 8%; P < 0.01). The frequency of patients who required ICU (72% vs. 19%), who developed acute kidney injury (14% vs. 1%) and acute respiratory distress syndrome (71%vs. 18%) were also higher in patients with cardiac injury. In multivariate analysis, age, coronary artery disease (CAD), elevated CRP levels, and presence of cardiac injury [odds ratio (OR) 10.58, 95% confidence interval (CI) 2.42-46.27; P < 0.001) were found to be independent predictors of mortality. In subgroup analysis, including patients free of history of CAD, presence of cardiac injury on admission also predicted mortality (OR 2.52, 95% CI 1.17-5.45; P = 0.018).

Conclusion: Cardiac injury on admission is associated with worse clinical outcome and higher mortality risk in COVID-19 patients including patients free of previous CAD diagnosis.

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Figures

Fig. 1.
Fig. 1.
Flowchart of the study.
Fig. 2.
Fig. 2.
High sensitive cardiac troponin I levels in all patients (a) and without CAD patients (b) who died and survived. CAD, coronary artery disease.
Fig. 3.
Fig. 3.
Kaplan–Meier survival curves for mortality during the time from admission. All patients (a) and patients without coronary artery disease (CAD) (b).
See this image and copyright information in PMC

References

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