A Cross-Sectional Study for Determining the Role of High-Sensitivity Cardiac Troponin T in Predicting 4-Month
1Health Sciences University Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Turkey.
Insights
Elevated cardiac troponin T levels in COVID-19 patients can predict 4-month mortality, with a threshold of 5.83 pg/ml. This biomarker aids in risk stratification beyond in-hospital outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomarkers
Background:
- Cardiac troponin positivity is common in hospitalized COVID-19 patients.
- Elevated troponins indicate a higher risk of in-hospital mortality and have prognostic importance.
- High-sensitive troponin T may predict longer-term mortality, extending beyond the initial hospital stay.
Purpose of the Study:
- To analyze the relationship between cardiac troponin T levels and 4-month mortality in COVID-19 patients.
- To evaluate cardiac troponin T as a risk stratification tool for COVID-19 outcomes.
- To determine specific thresholds for cardiac troponin T in predicting mortality.
Main Methods:
- Retrospective cross-sectional study of COVID-19 pneumonia patients during the first pandemic wave.
- Analysis included comorbidities, inflammatory markers (CRP, ferritin), liver enzymes (AST, ALT), cardiac biomarkers (troponin T, NT-proBNP), and coagulation parameters (INR).
- Survival status and duration of hospital stay were recorded.
Main Results:
- Cardiac troponin T > 0.53 pg/dL and aspartate transaminase (AST) > 26.5 U/L were associated with mortality.
- A cardiac troponin T threshold of 5.83 pg/mL predicted 4-month mortality with 82.8% sensitivity and 66.4% specificity.
- Mortality differences associated with troponin T levels were observed throughout the 4-month period.
Conclusions:
- Cardiac troponin T and AST are valuable indicators for predicting 4-month mortality in COVID-19 patients.
- A cardiac troponin T cutoff of 5.83 pg/mL can predict 4-month all-cause mortality.
- Lower cutoff values for cardiac troponin T may better reflect the prognostic extent of cardiac injury and associated mortality.
Background:
Positivity of cardiac troponins is common in hospitalized COVID-19 patients and may serve as an additional risk stratification tool in everyday clinical settings. Since patients with elevated troponins have a higher risk of in-hospital mortality, troponins have prognostic importance. As well as in-hospital mortality, high-sensitive troponin T may reflect 4-month mortality. We analyzed the relationship between cardiac troponin T levels and 4-month mortality of COVID-19.
Materials And Methods:
It was conducted as a retrospective cross-sectional study in Health Sciences University Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital Izmir, Turkey, with COVID-19 pneumonia patients during the first wave of the pandemic. We analyzed their comorbidities, C-reactive protein, ferritin, aspartate transaminase, alanine transaminase, cardiac troponin T, N-terminal-prohormone B-type-natriuretic peptide, international normalized ratio; duration of hospital stay, and survival status.
Results:
Factors associated with mortality were cardiac troponin T > 0.53 pg/dl (p = 0.009) and aspartate transaminase > 26.5 U/l (p = 0.012). The threshold for cardiac troponin T to predict 4-month mortality was 5.83pg/ml. Its sensitivity was 82.8% and its specificity was 66.4%.
Conclusion:
Cardiac troponin T and AST are indicators that can be used to predict 4-month mortality in addition to showing in-hospital mortality. The threshold for cardiac troponin T to predict 4-month all-cause mortality is 5.83pg/ml. The mortality difference persists at the beginning, middle, and end of the 4 months. Reference thresholds likely underestimate the true prognostic extent of cardiac injury and lower cutoff values may show mortality.
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