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. 2021 Jun 21;10(12):2726.
doi: 10.3390/jcm10122726.

B-Type Natriuretic Peptides and High-Sensitive Troponin I as COVID-19 Survival Factors: Which One Is the Best Performer?

Renato de Falco  1 , Maria Vargas  2 , Daniela Palma  1   3 , Marcella Savoia  1 , Anna Miscioscia  1 , Biagio Pinchera  4 , Martina Vano  1 , Giuseppe Servillo  2 , Ivan Gentile  4   5 , Giuliana Fortunato  1   3
Affiliations

B-Type Natriuretic Peptides and High-Sensitive Troponin I as COVID-19 Survival Factors: Which One Is the Best Performer?

Renato de Falco et al. J Clin Med. .

Abstract

Increased concentrations of B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (HsTnI) in COVID-19 patients have already been reported. The aim of this study is to evaluate which of these common markers of cardiac disease is the most useful predictor of fatal outcome in COVID-19 patients. One hundred and seventy-four patients affected with COVID-19 were recruited, and markers of cardiac disease and the clinical history of the patients were collected at admission in the infectious disease unit or intensive care unit. NT-proBNP, BNP and HsTnI values were higher in in-hospital non-surviving patients. Receiver operating characteristic (ROC) curve analysis of NT-proBNP, BNP and HsTnI was performed, with NT-proBNP (AUC = 0.951) and HsTnI (AUC = 0.947) being better performers (p = 0.01) than BNP (AUC = 0.777). Logistic regression was performed assessing the relation of HsTnI and NT-proBNP to fatal outcome adjusting for age and gender, with only NT-proBNP being significant. The population was then divided into two groups, one with higher NT-proBNP values at admission than the cut-off resulted from the ROC curve (511 ng/L) and a second one with lower values. The Kaplan-Meier analysis showed an absence of fatal outcome in the group of patients with NT-proBNP values lower than the cut-off (p < 0.001). NT-proBNP proved to be the best prognostic tool for fatal outcome among markers of cardiac disease in COVID-19 patients.

Keywords: BNP; COVID-19; NT-proBNP; fatal outcome; prognostic markers; troponin.

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Conflict of interest statement

I.G. acted as a consultant for Gilead, MSD, Abbvie, Pfizer, Nordic, Angelini, Correvio. All of the other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
ROC curves for NT-proBNP, BNP and HsTnI concentrations at admission. The receiver operating characteristic (ROC) curve is indicated with a line in bold and full circles represent the criterion points. The open circle indicates the cut-off point. The light line indicates the bisector and dotted lines indicate 95% confidence intervals.
Figure 2
Figure 2
Kaplan–Meier survival analysis between groups with highest value of NT-proBNP ratio higher or lower than 95 during hospital stay. Statistical difference evaluated with log-rank test.
See this image and copyright information in PMC

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