B-Type Natriuretic Peptides and High-Sensitive Troponin I as COVID-19 Survival Factors: Which One Is the Best Performer?
Open accessAbstract
Increased concentrations of B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (HsTnI) in COVID-19 patients have already been reported. The aim of this study is to evaluate which of these common markers of cardiac disease is the most useful predictor of fatal outcome in COVID-19 patients. One hundred and seventy-four patients affected with COVID-19 were recruited, and markers of cardiac disease and the clinical history of the patients were collected at admission in the infectious disease unit or intensive care unit. NT-proBNP, BNP and HsTnI values were higher in in-hospital non-surviving patients. Receiver operating characteristic (ROC) curve analysis of NT-proBNP, BNP and HsTnI was performed, with NT-proBNP (AUC = 0.951) and HsTnI (AUC = 0.947) being better performers (p = 0.01) than BNP (AUC = 0.777). Logistic regression was performed assessing the relation of HsTnI and NT-proBNP to fatal outcome adjusting for age and gender, with only NT-proBNP being significant. The population was then divided into two groups, one with higher NT-proBNP values at admission than the cut-off resulted from the ROC curve (511 ng/L) and a second one with lower values. The Kaplan–Meier analysis showed an absence of fatal outcome in the group of patients with NT-proBNP values lower than the cut-off (p < 0.001). NT-proBNP proved to be the best prognostic tool for fatal outcome among markers of cardiac disease in COVID-19 patients.
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In patients with severe COVID-19, elevated biomarkers of cardiac damage that predict heart failure including troponins and NT-proBNP were strongly and independently associated with in-hospital mortality.
“In patients with severe COVID-19, elevated biomarkers of cardiac damage that predict heart failure including troponins and NT-proBNP (N-terminal pro-B-type natriuretic peptide) were strongly and independently associated with in-hospital mortality.”
From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [72]
The Results and Discussion (page numbers not provided) report higher NT-proBNP and high-sensitivity troponin I in patients who died in hospital. However, only NT-proBNP remained significant after adjustment for age and sex, so the paper does not support calling both markers independent predictors; most enrolled patients were also non-critical rather than severe cases. (LLM, conf=0.90)
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- Authors
- de Falco, R., Vargas, M., Palma, D., Savoia, M., Miscioscia, A., Pinchera, B., Vano, M., Servillo, G., Gentile, I., & Fortunato, G.
- Affiliations
- Department of Biochemistry and Medical Biotechnology, University of Naples “Federico II”, Via Sergio Pansini 5, 80131 Naples, Italy
- University of Naples Federico II (IT)
- CEINGE Biotecnologie Avanzate Franco Salvatore (Italy) (IT)
- Federico II University Hospital (IT)
- Corresponding author
- Fortunato, Giuliana
- ORCID
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2021-06-21
- Volume
- 10
- Issue
- 12
- Pages
- 2726
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC8235158
- OpenAlex
- W3177486256
- Cited by
- 11
- References
- 31
- Citations by year
- 2023: 4 · 2022: 5 · 2021: 2
- FWCI
- 0.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- COVID-19 pandemic, brain natriuretic peptide, NT-proBNP, high-sensitivity troponin I, cardiac biomarkers, mortality prediction, prognostic factors, in-hospital mortality, SARS-CoV-2
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