scholarly journals The Prognostic Value of Myocardial Injury in COVID-19 Patients and Associated Characteristics

2021 ◽  
Author(s):  
jian he ◽  
Bicheng Zhang ◽  
Quan Zhou ◽  
Wenjing Yang ◽  
Jing Xu ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Myocardial Injury ◽  
Troponin I ◽  
Invasive Mechanical Ventilation ◽  
High Sensitivity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Mortality Incidence ◽  
Novel Coronavirus

Abstract Background: Since December 2019, Coronavirus disease 2019 (COVID-19) has emerged as an international pandemic. COVID-19 patients with myocardial injury might need special attention. However, understanding on this aspect remains unclear. This study aimed to illustrate clinical characteristics and the prognostic value of myocardial injury to COVID-19 patients. Methods: This retrospective, single-center study finally included 304 hospitalized COVID-19 cases confirmed by real-time RT-PCR from January 11 to March 25, 2020. Myocardial injury was determined by serum high-sensitivity troponin I (Hs-TnI). The primary endpoint was COVID-19 associated mortality. Results: Of 304 COVID-19 patients (median age, 65 years; 52.6% males), 88 patients (27.3%) died (61 patients with myocardial injury, 27 patients without myocardial injury on admission). COVID-19 patients with myocardial injury had more comorbidities (hypertension, chronic obstructive pulmonary disease, cardiovascular disease, and cerebrovascular disease); lower lymphocyte counts, higher C-reactive protein (CRP, median, 84.9 vs 28.5 mg/L, p<0.001), procalcitonin levels (median, 0.29 vs 0.06 ng/ml, p<0.001), inflammatory and immune response markers; more frequent need for noninvasive ventilation, invasive mechanical ventilation; and was associated with higher mortality incidence (hazard ratio, HR=7.02, 95% confidence interval, CI, 4.45-11.08, p<0.001) than those without myocardial injury. Myocardial injury (HR=4.55, 95% CI, 2.49-8.31, p<0.001), senior age, CRP levels, and novel coronavirus pneumonia (NCP) types on admission were independent predictors to mortality in COVID-19 patients. Conclusions: COVID patients with myocardial injury on admission is associated with more severe clinical presentation and biomarkers. Myocardial injury and higher HsTNI are both strongest independent predictors to COVID related mortality after adjusting confounding factors. In addition, senior age, CRP levels and NCP types are also associated with mortality. Trial registration: Not applicable.

scholarly journals Acute Myocardial Injury of Patients with Coronavirus Disease 2019

2020 ◽  
Author(s):  
Huayan Xu ◽  
Keke Hou ◽  
Hong Xu ◽  
Zhenlin Li ◽  
Huizhu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Injury ◽  
Cardiac Injury ◽  
Cardiac Complications ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Acute Myocardial Injury ◽  
Novel Coronavirus

AbstractBackgroundSince the outbreak of the Coronavirus Disease 2019 (COVID-19) in China, respiratory manifestations of the disease have been observed. However, as a fatal comorbidity, acute myocardial injury (AMI) in COVID-19 patients has not been previously investigated in detail. We investigated the clinical characteristics of COVID-19 patients with AMI and determined the risk factors for AMI in them.MethodsWe analyzed data from 53 consecutive laboratory-confirmed and hospitalized COVID-19 patients (28 men, 25 women; age, 19–81 years). We collected information on epidemiological and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, imaging findings, management methods, and clinical outcomes.ResultsCardiac complications were found in 42 of the 53 (79.25%) patients: tachycardia (n=15), electrocardiography abnormities (n=11), diastolic dysfunction (n=20), elevated myocardial enzymes (n=30), and AMI (n=6). All the six AMI patients were aged >60 years; five of them had two or more underlying comorbidities (hypertension, diabetes, cardiovascular diseases, and chronic obstructive pulmonary disease). Novel coronavirus pneumonia (NCP) severity was higher in the AMI patients than in patients with non-definite AMI (p<0.001). All the AMI patients required care in intensive care unit; of them, three died, two remain hospitalized. Multivariate analyses showed that C-reactive protein (CRP) levels, NCP severity, and underlying comorbidities were the risk factors for cardiac abnormalities in COVID-19 patients.ConclusionsCardiac complications are common in COVID-19 patients. Elevated CRP levels, underlying comorbidities, and NCP severity are the main risk factors for cardiac complications in COVID-19 patients.

scholarly journals Markers of Myocardial Stress, Myocardial Injury, and Subclinical Inflammation and the Risk of Sudden Death

Circulation ◽  
2020 ◽  
Vol 142 (12) ◽  
pp. 1148-1158
Author(s):  
Brendan M. Everett ◽  
M.V. Moorthy ◽  
Jani T. Tikkanen ◽  
Nancy R. Cook ◽  
Christine M. Albert
Keyword(s):  
Cardiovascular Disease ◽  
High Density Lipoprotein ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Cholesterol Ratio ◽  
Reactive Protein

Background: The majority of sudden cardiac deaths (SCDs) occur in low-risk populations often as the first manifestation of cardiovascular disease (CVD). Biomarkers are screening tools that may identify subclinical cardiovascular disease and those at elevated risk for SCD. We aimed to determine whether the total to high-density lipoprotein cholesterol ratio, high-sensitivity cardiac troponin I, NT-proBNP (N-terminal pro-B-type natriuretic peptide), or high-sensitivity C-reactive protein individually or in combination could identify individuals at higher SCD risk in large, free-living populations with and without cardiovascular disease. Methods: We performed a nested case-control study within 6 prospective cohort studies using 565 SCD cases matched to 1090 controls (1:2) by age, sex, ethnicity, smoking status, and presence of cardiovascular disease. Results: The median study follow-up time until SCD was 11.3 years. When examined as quartiles or continuous variables in conditional logistic regression models, each of the biomarkers was significantly and independently associated with SCD risk after mutually controlling for cardiac risk factors and other biomarkers. The mutually adjusted odds ratios for the top compared with the bottom quartile were 1.90 (95% CI, 1.30–2.76) for total to high-density lipoprotein cholesterol ratio, 2.59 (95% CI, 1.76–3.83) for high-sensitivity cardiac troponin I, 1.65 (95% CI, 1.12–2.44) for NT-proBNP, and 1.65 (95% CI, 1.13–2.41) for high-sensitivity C-reactive protein. A biomarker score that awarded 1 point when the concentration of any of those 4 biomarkers was in the top quartile (score range, 0–4) was strongly associated with SCD, with an adjusted odds ratio of 1.56 (95% CI, 1.37–1.77) per 1-unit increase in the score. Conclusions: Widely available measures of lipids, subclinical myocardial injury, myocardial strain, and vascular inflammation show significant independent associations with SCD risk in apparently low-risk populations. In combination, these measures may have utility to identify individuals at risk for SCD.

Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters

2017 ◽  
Vol 3 (2) ◽  
pp. 50-54
Author(s):  
Mamatha B Patil ◽  
M Abhishek ◽  
BK Pradeep
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Airflow Obstruction ◽  
High Sensitivity ◽  
Chronic Obstructive ◽  
Clinical Parameters ◽  
C Reactive Protein ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Hs Crp

ABSTRACT Introduction Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. By 2020, the World Health Organization predicts that COPD will become the third leading cause of death and the fifth leading cause of disability worldwide. The COPD is a complex disease characterized by slowly progressive and largely irreversible airflow obstruction due to chronic bronchitis and emphysema and associated with systemic inflammation. Objective This study aimed to correlate the plasma levels of high-sensitivity C-reactive protein (hs-CRP) with severity of COPD and pulmonary function tests [PFTs; according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages] and find out the relation between hs-CRP levels and clinical parameters of age, number of pack years, and body mass index (BMI) of the patient. Materials and methods A cross-sectional study of 102 male patients with clinically and spirometrically diagnosed cases of COPD was performed. Data on patient's demographic characteristics, pack years, BMI, PFTs, and hs-CRP were analyzed. Results A total of 76 of the patients had moderate airflow obstruction (GOLD stages II and III), mild airflow obstruction was present in 14 patients (GOLD stage I), and 12 patients had severe airflow obstruction (GOLD stage IV). The hs-CRP was normal in 6 patients, while it was raised in 96 patients. The value of hs-CRP was correlated with age, pack years, BMI, and GOLD stages. There was a significant negative correlation between hs-CRP and BMI and a significant positive correlation between hs-CRP and age, pack years, and GOLD stages. Conclusion A raised level of CRP in COPD indicates reduced lung function; it plays an important role in systemic inflammation. This study supports the role of hs-CRP as a simple, cost-effective biochemical marker in the staging and determining the severity of COPD other than spirometry. How to cite this article Patil MB, Abhishek M, Pradeep BK. Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters. J Med Sci 2017;3(2):50-54.

Presence of Renal Simple Cysts Is Associated With Increased Risk of Abdominal Aortic Aneurysms

Angiology ◽  
2014 ◽  
Vol 71 (5) ◽  
pp. 465-470 ◽  
Author(s):  
Bong Gun Song ◽  
Yong Hwan Park
Keyword(s):  
Screening Program ◽  
High Sensitivity ◽  
Aortic Aneurysms ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Structural Weakness

We compared the incidence of renal simple cysts in 271 patients with abdominal aortic aneurysm (AAA) and 1387 patients without AAA (controls) using computed tomography (CT) angiography and abdominal CT, as a health screening program. The AAA group had significantly higher prevalence of renal simple cysts (55% vs 19%, P = .001) and chronic obstructive pulmonary disease (COPD; 12% vs 1%, P = .011) than the controls. After propensity score matching (n = 164), the prevalence of renal simple cysts was still significantly higher in the AAA group. In multivariate analysis, independent predictors of AAA were age, male gender, smoking history, hypertension, high-sensitivity C-reactive protein, creatinine, COPD, and renal simple cysts. The structural weakness predisposing for renal simple cysts may be associated with the initiation of AAA formation. More studies are needed to determine whether the presence of renal simple cysts can be considered as a risk factor for AAA.

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