Cardiac Troponin for Assessment of Myocardial Injury in COVID-19: JACC Review Topic of the Week

Yader Sandoval, James L. Januzzi, Allan S. Jaffe

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Increases in cardiac troponin indicative of myocardial injury are common in patients with coronavirus disease-2019 (COVID-19) and are associated with adverse outcomes such as arrhythmias and death. These increases are more likely to occur in those with chronic cardiovascular conditions and in those with severe COVID-19 presentations. The increased inflammatory, prothrombotic, and procoagulant responses following severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection increase the risk for acute nonischemic myocardial injury and acute myocardial infarction, particularly type 2 myocardial infarction, because of respiratory failure with hypoxia and hemodynamic instability in critically ill patients. Myocarditis, stress cardiomyopathy, acute heart failure, and direct injury from SARS-CoV-2 are important etiologies, but primary noncardiac conditions, such as pulmonary embolism, critical illness, and sepsis, probably cause more of the myocardial injury. The structured use of serial cardiac troponin has the potential to facilitate risk stratification, help make decisions about when to use imaging, and inform stage categorization and disease phenotyping among hospitalized COVID-19 patients.

Original languageEnglish (US)
Pages (from-to)1244-1258
Number of pages15
JournalJournal of the American College of Cardiology
Volume76
Issue number10
DOIs
StatePublished - Sep 8 2020

Keywords

  • cardiac troponin
  • coronavirus disease 2019
  • myocardial injury
  • type 2 myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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