Myocardial injury common, but mortality risk not higher with concomitant COVID-19 diagnosis
In a new study, myocardial injury was common among patients with suspected COVID-19, but the risk for death from myocardial injury was not higher with a positive COVID-19 diagnosis.
Results of a prospective trial, presented at the European Society of Cardiology Congress, evaluated high-sensitivity troponin I tests (ArchitectStat assay; Abbott) collected from April 21 to July 31, 2020, from 2,916 consecutive patients (median age, 69 years; 53% women) with suspected COVID-19 hospitalized at three acute care hospitals in Scotland. Patients were followed up for an average of 228 days.
The researchers evaluated the prognostic role of myocardial injury in COVID-19 and the underlying mechanisms of injury.
“Myocardial injury was present in one in four patients, with a slightly higher prevalence in those with confirmed COVID-19,” Anda Bularga, MBChB, clinical research fellow at the BHF Centre for Cardiovascular Science, University of Edinburgh, U.K., said during a presentation. “The majority of patients had acute ischemic myocardial injury [and] myocardial injury was associated with a doubling in risk for all-cause death at 6 months, but this excess was not higher in patients with confirmed COVID-19.”
According to the study, myocardial injury occurred in 26% of the cohort. Myocardial injury was present in 41% of patients who tested positive for COVID-19 and 25% of patients who tested negative.
Among those with myocardial injury, the most common mechanism, nonischemic myocardial injury, occurred in 80% of patients with COVID-19 and 71% of patients hospitalized for another illness, without COVID-19. According to the study, type 1 and type 2 MI as well as chronic myocardial injury were far less common in either group.
Moreover, myocardial injury was an independent predictor of all-cause death in all patients (adjusted HR = 2.05; 95% CI, 1.72-2.45), whether patients tested positive for COVID-19 or not (HR for COVID-19 negative = 1.95; 95% CI, 1.61-2.36; HR for COVID-19 positive = 1.24; 95% CI, 1.08-5.09).
“We observed that the excess risk for death associated with myocardial injury is not higher in patients with confirmed COVID-19 compared to those without,” Bularga said during the presentation.
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Bularga A, et al. Live Abstracts: COVID-19 and Acute Coronary Syndromes. Presented at: European Society of Cardiology Congress; Aug. 27-30, 2021 (virtual meeting).