TY - JOUR T1 - Early detection of elevated cardiac biomarkers to optimise risk stratification in patients with COVID-19 JF - Heart JO - Heart SP - 1512 LP - 1518 DO - 10.1136/heartjnl-2020-317322 VL - 106 IS - 19 AU - Giulio G. Stefanini AU - Mauro Chiarito AU - Giuseppe Ferrante AU - Francesco Cannata AU - Elena Azzolini AU - Giacomo Viggiani AU - Andrea De Marco AU - Martina Briani AU - Monica Bocciolone AU - Renato Bragato AU - Elena Corrada AU - Gabriele L Gasparini AU - Manuel Marconi AU - Lorenzo Monti AU - Paolo A Pagnotta AU - Cristina Panico AU - Daniela Pini AU - Damiano Regazzoli AU - Ilaria My AU - Marinos Kallikourdis AU - Michele Ciccarelli AU - Salvatore Badalamenti AU - Alessio Aghemo AU - Bernhard Reimers AU - Gianluigi Condorelli A2 - , Y1 - 2020/10/01 UR - http://heart.bmj.com/content/106/19/1512.abstract N2 - Objective Risk stratification is crucial to optimise treatment strategies in patients with COVID-19. We aimed to evaluate the impact on mortality of an early assessment of cardiac biomarkers in patients with COVID-19.Methods Humanitas Clinical and Research Hospital (Rozzano-Milan, Lombardy, Italy) is a tertiary centre that has been converted to the management of COVID-19. Patients with confirmed COVID-19 were entered in a dedicated database for cohort observational analyses. Outcomes were stratified according to elevated levels (ie, above the upper level of normal) of high-sensitivity cardiac troponin I (hs-TnI), B-type natriuretic peptide (BNP) or both measured within 24 hours after hospital admission. The primary outcome was all-cause mortality.Results A total of 397 consecutive patients with COVID-19 were included up to 1 April 2020. At the time of hospital admission, 208 patients (52.4%) had normal values for cardiac biomarkers, 90 (22.7%) had elevated both hs-TnI and BNP, 59 (14.9%) had elevated only BNP and 40 (10.1%) had elevated only hs-TnI. The rate of mortality was higher in patients with elevated hs-TnI (22.5%, OR 4.35, 95% CI 1.72 to 11.04), BNP (33.9%, OR 7.37, 95% CI 3.53 to 16.75) or both (55.6%, OR 18.75, 95% CI 9.32 to 37.71) as compared with those without elevated cardiac biomarkers (6.25%). A multivariate analysis identified concomitant elevation of both hs-TnI and BNP as a strong independent predictor of all-cause mortality (OR 3.24, 95% CI 1.06 to 9.93).Conclusions An early detection of elevated hs-TnI and BNP predicts mortality in patients with COVID-19. Cardiac biomarkers should be systematically assessed in patients with COVID-19 at the time of hospital admission in order to optimise risk stratification. ER -