46038af391d2bad5136c62e21400b7f4 pmc_34945166.pdf cb677f2718953a77f946b8b2b0adfa2fe0813fa8 pmc_34945166.pdf 70fbd7cf2f8a8f31b13f9e5fa133ddb4bd4807e3b21865766a131bb9e20e70c7 pmc_34945166.pdf Title: Biomarkers Predict In-Hospital Major Adverse Cardiac Events in COVID-19 Patients: A Multicenter International Study Subject: Background: The COVID-19 pandemic carries a high burden of morbidity and mortality worldwide. We aimed to identify possible predictors of in-hospital major cardiovascular (CV) events in COVID-19. Methods: We retrospectively included patients hospitalized for COVID-19 from 10 centers. Clinical, biochemical, electrocardiographic, and imaging data at admission and medications were collected. Primary endpoint was a composite of in-hospital CV death, acute heart failure (AHF), acute myocarditis, arrhythmias, acute coronary syndromes (ACS), cardiocirculatory arrest, and pulmonary embolism (PE). Results: Of the 748 patients included, 141(19%) reached the set endpoint: 49 (7%) CV death, 15 (2%) acute myocarditis, 32 (4%) sustained-supraventricular or ventricular arrhythmias, 14 (2%) cardiocirculatory arrest, 8 (1%) ACS, 41 (5%) AHF, and 39 (5%) PE. Patients with CV events had higher age, body temperature, creatinine, high-sensitivity troponin, white blood cells, and platelet counts at admission and were more likely to have systemic hypertension, renal failure (creatinine 1.25 mg/dL), chronic obstructive pulmonary disease, atrial fibrillation, and cardiomyopathy. On univariate and multivariate analysis, troponin and renal failure were associated with the composite endpoint. Kaplan–Meier analysis showed a clear divergence of in-hospital composite event-free survival stratified according to median troponin value and the presence of renal failure (Log rank p < 0.001). Conclusions: Our findings, derived from a multicenter data collection study, suggest the routine use of biomarkers, such as cardiac troponin and serum creatinine, for in-hospital prediction of CV events in patients with COVID-19. Keywords: COVID-19; SARS-CoV2; biomarkers; troponin; creatinine; prognosis Author: Michael Y. Henein, Giulia Elena Mandoli, Maria Concetta Pastore, Nicolò Ghionzoli, Fouhad Hasson, Muhammad K. Nisar, Mohammed Islam, Francesco Bandera, Massimiliano M. Marrocco-Trischitta, Irene Baroni, Alessandro Malagoli, Luca Rossi, Andrea Biagi, Rodolfo Citro, Michele Ciccarelli, Angelo Silverio, Giulia Biagioni, Joseph A. Moutiris, Federico Vancheri, Giovanni Mazzola, Giulio Geraci, Liza Thomas, Mikhail Altman, John Pernow, Mona Ahmed, Ciro Santoro, Roberta Esposito, Guillem Casas, Rubén Fernández-Galera, Maribel Gonzalez, Jose Rodriguez Palomares, Ibadete Bytyçi, Frank Lloyd Dini, Paolo Cameli, Federico Franchi, Gani Bajraktari, Luigi Paolo Badano and Matteo Cameli Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Dec 16 18:10:36 2021 CET ModDate: Mon Dec 20 07:39:50 2021 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 986073 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MCFTDZ+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 ZHOANP+VnURWPalladioL Type 1 Custom yes yes no 15 0 QCOCVO+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 TLZIPW+URWPalladioL-Bold Type 1 Custom yes yes no 24 0 GTTDAL+URWPalladioL-Roma Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 PHPDYL+CMSY10 Type 1 Builtin yes yes no 81 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 91 0 JAJGJL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 101 0 JAJGKM+PalatinoLinotype TrueType WinAnsi yes yes no 104 0 JAJGKO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 107 0 JAJGJL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 118 0 JAJGKM+PalatinoLinotype TrueType WinAnsi yes yes no 121 0 JAJGKO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 124 0 JAJGJL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 135 0 JAJGKM+PalatinoLinotype TrueType WinAnsi yes yes no 138 0 JAJGKO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 141 0 JAJIEH+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 144 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:37:37 CEST RepresentationInformation: pmc_34945166.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:06:35 CEST Size: 986073 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 295 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Study Outcomes Destination: subsection.2.2 Item: Title: Statistical Analysis Destination: subsection.2.3 Item: Title: Results Destination: section.3 Children: Item: Title: Follow-Up Destination: subsection.3.1 Item: Title: Clinical and Biohumoral Characteristics Destination: subsection.3.2 Item: Title: Biomarkers Associated with In-Hospital Cardiovascular Events Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Children: Item: Title: Renal Disease in COVID-19 Destination: subsection.4.1 Item: Title: The Use of Cardiac Troponin in COVID-19 Destination: subsection.4.2 Item: Title: Limitations Destination: subsection.4.3 Item: Title: Conclusions Destination: section.5 Item: Title: Destination: section.A. Item: Title: References Destination: specialtable.caption.7 Info: Title: Biomarkers Predict In-Hospital Major Adverse Cardiac Events in COVID-19 Patients: A Multicenter International Study Author: Michael Y. Henein, Giulia Elena Mandoli, Maria Concetta Pastore, Nicolò Ghionzoli, Fouhad Hasson, Muhammad K. Nisar, Mohammed Islam, Francesco Bandera, Massimiliano M. Marrocco-Trischitta, Irene Baroni, Alessandro Malagoli, Luca Rossi, Andrea Biagi, Rodolfo Citro, Michele Ciccarelli, Angelo Silverio, Giulia Biagioni, Joseph A. Moutiris, Federico Vancheri, Giovanni Mazzola, Giulio Geraci, Liza Thomas, Mikhail Altman, John Pernow, Mona Ahmed, Ciro Santoro, Roberta Esposito, Guillem Casas, Rubén Fernández-Galera, Maribel Gonzalez, Jose Rodriguez Palomares, Ibadete Bytyçi, Frank Lloyd Dini, Paolo Cameli, Federico Franchi, Gani Bajraktari, Luigi Paolo Badano and Matteo Cameli Subject: Background: The COVID-19 pandemic carries a high burden of morbidity and mortality worldwide. We aimed to identify possible predictors of in-hospital major cardiovascular (CV) events in COVID-19. Methods: We retrospectively included patients hospitalized for COVID-19 from 10 centers. Clinical, biochemical, electrocardiographic, and imaging data at admission and medications were collected. Primary endpoint was a composite of in-hospital CV death, acute heart failure (AHF), acute myocarditis, arrhythmias, acute coronary syndromes (ACS), cardiocirculatory arrest, and pulmonary embolism (PE). Results: Of the 748 patients included, 141(19%) reached the set endpoint: 49 (7%) CV death, 15 (2%) acute myocarditis, 32 (4%) sustained-supraventricular or ventricular arrhythmias, 14 (2%) cardiocirculatory arrest, 8 (1%) ACS, 41 (5%) AHF, and 39 (5%) PE. Patients with CV events had higher age, body temperature, creatinine, high-sensitivity troponin, white blood cells, and platelet counts at admission and were more likely to have systemic hypertension, renal failure (creatinine 1.25 mg/dL), chronic obstructive pulmonary disease, atrial fibrillation, and cardiomyopathy. On univariate and multivariate analysis, troponin and renal failure were associated with the composite endpoint. Kaplan Meier analysis showed a clear divergence of in-hospital composite event-free survival stratified according to median troponin value and the presence of renal failure (Log rank p < 0.001). Conclusions: Our findings, derived from a multicenter data collection study, suggest the routine use of biomarkers, such as cardiac troponin and serum creatinine, for in-hospital prediction of CV events in patients with COVID-19. Keywords: COVID-19; SARS-CoV2; biomarkers; troponin; creatinine; prognosis Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Dec 16 18:10:36 CET 2021 ModDate: Mon Dec 20 07:39:50 CET 2021 ID: 0xb3f87c27bc424310a5c2d97554de33c7, 0xb3f87c27bc424310a5c2d97554de33c7 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: PHPDYL+CMSY10 FontSubset: true FirstChar: 6 LastChar: 21 FontDescriptor: FontName: PHPDYL+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: QCOCVO+URWPalladioL-Ital FontSubset: true FirstChar: 3 LastChar: 121 FontDescriptor: FontName: QCOCVO+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TLZIPW+URWPalladioL-Bold FontSubset: true FirstChar: 2 LastChar: 231 FontDescriptor: FontName: TLZIPW+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: 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