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Association of Abnormal Cardiac Biomarkers and Cardiovascular Complications, with Mortality in Patients with SARS-CoV-2 Infection in Latin America

Gómez-Mesa J.E.; Escalante M.; Muñoz-Ordoñez J.A.; Azcárate-Rodriguez V.; Peláez-Martínez J.D.; Arteaga-Tobar A.A.; León-Giraldo H.; Valencia-Orozco A.; Perna E.R.; Romero A.; Mendoza I.; Wyss F.; Barisani J.L.; Speranza M.; Alarco W.; Herrera C.; Lugo-Peña J.; Cárdenas-Aldaz L.P.; Rossel V.; Sierra D. · Journal of Cardiovascular Development and Disease (2024) · DOI: 10.3390/jcdd11070205

Resumen

Background: The COVID-19 pandemic has highlighted a correlation between cardiac complications and elevated cardiac biomarkers, which are linked to poorer clinical outcomes. Objective: This study aims to determine the clinical impact of cardiac biomarkers in COVID-19 patients in Latin America. Subjects and methods: The CARDIO COVID 19-20 Registry is a multicenter observational study across 44 hospitals in Latin America and the Caribbean. It included hospitalized COVID-19 patients (n = 476) who underwent troponin, natriuretic peptide, and D-dimer tests. Patients were grouped based on the number of positive biomarkers. Results: Among the 476 patients tested, 139 had one positive biomarker (Group C), 190 had two (Group B), 118 had three (Group A), and 29 had none (Group D). A directly proportional relationship was observed between the number of positive biomarkers and the incidence of decompensated heart failure. Similarly, there was a proportional relationship between the number of positive biomarkers and increased mortality. In Group B, patients with elevated troponin and natriuretic peptide and those with elevated troponin and D-dimer had 1.4 and 1.5 times higher mortality, respectively, than those with elevated natriuretic peptide and D-dimer. Conclusions: In Latin American COVID-19 patients, a higher number of positive cardiac biomarkers is associated with increased cardiovascular complications and mortality. These findings suggest that cardiac biomarkers should be utilized to guide acute-phase treatment strategies.