心肌损伤对院内及新冠肺炎患者住院临床结局的影响

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Pooja Vyas, Ashish Mishra, Kunal Parwani, Iva Patel, Dhara Dhokia, Trishul Amin, Prarthi Shah, Tanmay Boob, Rujuta Parikh, Radhakishan Dake, Khamir Banker
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引用次数: 0

摘要

以肌钙蛋白I水平升高为定义的急性心肌损伤与COVID-19患者的不良住院结局和心血管并发症相关。本研究旨在确定COVID-19心肌损伤的影响和临床结果。方法:回顾性研究纳入住院的COVID-19患者。心肌损伤以高敏感性肌钙蛋白I (hs-TNI)≥26ng/l为标准。系统收集和分析心脏生物标志物、炎症标志物和临床数据。分析住院死亡率的危险比和急性心肌损伤预测因子的logistic回归。结果:1821例新冠肺炎患者中,死亡293例(16.09%),存活1528例(83.91%)。与存活组相比,死亡患者与心血管危险因素、严重CTSS (CT严重程度评分)和心肌损伤的相关性显著升高。628例(34.5%)患者有心肌损伤的证据,与心血管危险因素、住院死亡率、降钙素原有统计学意义的相关性;高级医院和重症监护室我们发现糖尿病(HR=2.66, (CI:1.65-4.29))、严重CT评分(HR=2.81, (CI:1.74-4.52))、hs-TNI≥26 ng/l (HR=4.68, (CI:3.81-5.76))的死亡率风险比显著。回归分析发现重度CTSS评分(OR=1.95, CI: 1.18 ~ 3.23, P=0.01)和既往CVD史(OR=1.65, CI:1.00 ~ 2.73, P=0.05)是心肌损伤的显著预测因子。结论:近三分之一的住院患者在住院期间出现急性心肌损伤。急性心肌损伤与较高的住院和icu住院时间、死亡率、较高的院内感染相关,这表明疾病更严重,院内预后较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Significance of myocardial injury on in-hospital clinical outcomes of in-hospital and COVID-19 patients.

Introduction: Acute Myocardial injury defined by increased troponin I level is associated with poor in-hospital outcomes and cardiovascular complications in patients with COVID-19. The current study was designed to determine the implications and clinical outcome of myocardial injury in COVID-19.

Methods: This retrospective study included hospitalized COVID-19 patients. Myocardial injury was defined by high sensitivity Troponin I (hs-TNI)≥26ng/l. Cardiac biomarkers, inflammatory markers and clinical data were systemically collected and analyzed. Hazard ratio for in-hospital mortality and logistic regression for predictors of acute myocardial injury were analyzed.

Results: Of the 1821 total patients with COVID-19, 293(16.09%) patients died and 1528 (83.91%) patients survived. Patients who died had significantly higher association with presence of cardiovascular risk factors, severe CTSS ( CT severity score ) and myocardial injury as compared to survived group. 628 (34.5%) patients had evidence of myocardial injury and they had statistically significant association with cardiovascular risk factors, in-hospital mortality, procalcitonin; higher hospital, and ICCU stay. We found significant hazard ratio of diabetes (HR=2.66, (CI:1.65-4.29)), Severe CT score (HR=2.81, (CI:1.74-4.52)), hs-TNI≥26 ng/l (HR=4.68, (CI:3.81-5.76)) for mortality. Severe CTSS score (OR=1.95, CI: 1.18-3.23, P=0.01) and prior CVD history (OR=1.65, CI:1.00-2.73, P=0.05) were found significant predictors of myocardial injury in regression analysis.

Conclusion: Almost one third of hospitalized patients had evidence of acute myocardial injury during hospitalization. Acute myocardial injury is associated with higher hospital and ICCU stay, mortality, higher in-hospital infection which indicates more severe disease and the poor in-hospital outcomes.

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来源期刊
Journal of Cardiovascular and Thoracic Research
Journal of Cardiovascular and Thoracic Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.00
自引率
0.00%
发文量
22
审稿时长
7 weeks
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