Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan:104:104822.
doi: 10.1016/j.archger.2022.104822. Epub 2022 Sep 20.

Admission high-sensitivity cardiac troponin levels as a prognostic indicator for in-hospital mortality rates in the elderly and very elderly COVID-19 patients

Alessio Menditto  1 , Olga Protic  2 , Mirko Di Rosa  3 , Anna Rita Bonfigli  4 , Fabrizia Lattanzio  4 , Roberto Antonicelli  2
Affiliations

Admission high-sensitivity cardiac troponin levels as a prognostic indicator for in-hospital mortality rates in the elderly and very elderly COVID-19 patients

Alessio Menditto et al. Arch Gerontol Geriatr. 2023 Jan.

Abstract

Background: Elevation of cardiac troponin (cTn) is associated with the worst prognosis not only in cardiovascular disease but also in non-cardiovascular disease. The aim of this study is to verify if cTn has a prognostic role in elderly and very elderly coronavirus disease 2019 (COVID-19) patients.

Methods: This study enrolled consecutive COVID-19 elderly patients hospitalized at INRCA hospital, with available admission high sensitivity cardiac troponin T (HS-cTnT) level. Patients were divided into three groups based on HS-cTnT level: group A (Hs-cTnT ≤ 40 pg/ml), group B (Hs-cTnT 41-100 pg/ml), and group C (Hs-cTnT ≥ 101 pg/ml). The correlation between HS-cTnT levels and mortality rates was analyzed.

Results: 461 patients (mean age 86 years; 59% female) were divided into group A (261 patients), group B (129 patients), and group C (71 patients). Group C resulted significantly older, more affected by heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and dementia, and with higher levels of creatinine, C-reactive protein, pro-calcitonin, interleukin-6, ferritin, NT-proBNP, D-dimer then group A and group B. Mortality rate increased significantly across groups (group A: 18.4%; group B: 36.4%; group C: 62.0%; p<0.001). Group C had a significant increase in mortality risk compared to group A, both univariate analysis (HR 3.78) and multivariate analysis (model 2 HR 3.10; model 3 HR 3.59; model 4 HR 1.72).

Conclusion: HS-cTnT has demonstrated a prognostic role in elderly and very elderly COVID-19 patients. HS-cTnT is a simple and inexpensive laboratory exam that gives clinicians important information on mortality risk stratification.

Keywords: COVID-19; Elderly; High-sensitivity cardiac troponin assay; Mortality; SARSCov2; Troponin.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest None to declare

Figures

Fig 1
Fig. 1
Kaplan-Meier curve for in-hospital mortality according to HS-cTnT entry levels. Log-rank test for equality of survivor functions (p<0.001).
See this image and copyright information in PMC

References

    1. Forman D.E., de Lemos J.A., Shaw L.J., Reuben D.B., Lyubarova R., Peterson E.D., Spertus J.A., Zieman S., Salive M.E., Rich M.W., et al. Cardiovascular biomarkers and imaging in older adults: JACC council perspectives. Journal of the American College of Cardiology. 2020;76:1577–1594. doi: 10.1016/j.jacc.2020.07.055. - DOI - PMC - PubMed
    1. Conway R., Byrne D., Cournane S., O'Riordan D., Coveney S., Silke B. Is there excessive troponin testing in clinical practice? Evidence from emergency medical admissions. European Journal of International Medicine. 2021;86:48–53. doi: 10.1016/j.ejim.2020.12.009. - DOI - PubMed
    1. Thygesen K., Alpert J.S., Jaffe A.S., Chaitman B.R., Bax J.J., Morrow D.A., White H.D. Fourth universal definition of myocardial infarction (2018) Circulation. 2018;138:e618–e651. doi: 10.1161/cir.0000000000000617. - DOI - PubMed
    1. Willeit P., Welsh P., Evans J.D.W., Tschiderer L., Boachie C., Jukema J.W., Ford I., Trompet S., Stott D.J., Kearney P.M., et al. High-sensitivity cardiac troponin concentration and risk of first-ever cardiovascular outcomes in 154,052 participants. Journal of the American College of Cardiology. 2017;70:558–568. doi: 10.1016/j.jacc.2017.05.062. - DOI - PMC - PubMed
    1. Sedighi S.M., Prud'Homme P., Ghachem A., Lepage S., Nguyen M., Fulop T., Khalil A. Increased level of high-sensitivity cardiac Troponin T in a geriatric population is determined by comorbidities compared to age. International Journal of Cardiology and Heart Vasc. 2019;22:187–191. doi: 10.1016/j.ijcha.2019.02.015. - DOI - PMC - PubMed