» Articles » PMID: 38601195

Predictors and Clinical Significance of Myocardial Injury in Elderly Patients Under the COVID-19 Pandemic

Overview
Journal Int J Gen Med
Publisher Dove Medical Press
Specialty General Medicine
Date 2024 Apr 11
PMID 38601195
Authors
Affiliations
Soon will be listed here.
Abstract

Background: The elderly patients are at increased high risk of myocardial injury and mortality after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to investigate the prevalence, predictors and prognostic implications of myocardial injury in the elderly patients with SARS-CoV-2 infection.

Methods: Patients aged over 65 years were consecutively recruited between April to May, 2022. Myocardial injury was assessed using the high-sensitivity cardiac troponin T (hs-cTnT) assay. The primary endpoint was in-hospital mortality.

Results: A total of 347 patients were recruited with a median age of 81 years. 45.8% were male and 18 (5.2%) deceased before discharge. Myocardial injury (hs-cTnT over 99% upper reference limit [URL]) was detected in 202 (58.2%) of patients. Predictors of myocardial injury included age (per 5-year increase), hypertension, vaccination, creatine, and neutrophil-to-lymphocyte ratio. hs-cTnT over 3 × URL was independently correlated with in-hospital mortality (adjusted odds ratio [adOR], 13.21; 95% confidence interval [CI], 2.11-87.1; p = 0.005) in comparison to hs-cTnT > URL (adOR, 0.66; 95% CI, 0.09-5.92; p = 0.680).

Conclusion: Myocardial injury was a common phenomenon and prognostic predictor in elder patients after SARS-CoV-2 infection. Higher threshold of myocardial injury may be considered to improve risk stratification.

References
1.
Lam F, Cruz M, Leung H, Parikh K, Smith C, Rumbaut R . Histone induced platelet aggregation is inhibited by normal albumin. Thromb Res. 2013; 132(1):69-76. DOI: 10.1016/j.thromres.2013.04.018. View

2.
Roh J, Kitchen R, Guseh J, McNeill J, Aid M, Martinot A . Plasma Proteomics of COVID-19-Associated Cardiovascular Complications: Implications for Pathophysiology and Therapeutics. JACC Basic Transl Sci. 2022; 7(5):425-441. PMC: 9067411. DOI: 10.1016/j.jacbts.2022.01.013. View

3.
Thygesen K, Alpert J, Jaffe A, Chaitman B, Bax J, Morrow D . Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018; 72(18):2231-2264. DOI: 10.1016/j.jacc.2018.08.1038. View

4.
De Michieli L, Ola O, Knott J, Akula A, Mehta R, Hodge D . High-Sensitivity Cardiac Troponin T for the Detection of Myocardial Injury and Risk Stratification in COVID-19. Clin Chem. 2021; 67(8):1080-1089. PMC: 8083261. DOI: 10.1093/clinchem/hvab062. View

5.
Arques S . Human serum albumin in cardiovascular diseases. Eur J Intern Med. 2018; 52:8-12. DOI: 10.1016/j.ejim.2018.04.014. View