Independent Predictors of Mortality in COVID-19 Myocardial Injury: The Role of Troponin Levels, GRACE Score, SOFA Score, and TIMI Score

Raj, Kavin; Mahajan, Pranav; Watts, Abi; Aedma, Surya Kiran; Jose, Jemin Aby; Pillai, Keerthana Jyotheeswara; Rizkalla, Adam; Sharma, Suyansh; Upadhyay, Riddhi; Dhobale, Swati; Farooq, Talha Bin; Khanam, Rukhsaar; Patel, Keval V; Martin, Randolph P.

doi:10.7759/cureus.32082

Cited by 2 publications

(4 citation statements)

References 15 publications

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“…Cycloheximide (5-HT2A and 5-HT 2 B antagonists) administered after lower extremity MI reduced 5-HT levels while preventing valvular fibrotic remodeling was associated with increased mitral valve size and reduced mitral regurgitation (38). Additionally, SOFA score was an independent predictor of mortality in patients with myocardial injury (39). In this study, lower SOFA and SAPS II scores were observed in the OND-medication group, indicting OND might exert its protective effect through relieving disease severity in patients with MI.…”

Section: Discussionmentioning

confidence: 99%

“…In the matched cohort, in-hospital mortality (5.7% vs 8.0%), 28-day mortality (7.8% vs 10.8%), and 90-day mortality (9.2% vs 12.5%) rates were significantly lower in patients treated with OND. In terms of disease severity, there were lower SOFA (35(28-43) vs. 36 (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)) and SAPS II (4(2-6) vs. 4(2-7)) in the OND-medication group.…”

Section: Clinical Outcomes After Psmmentioning

confidence: 96%

“…P-values for log-rank tests were lower than 0.05. Additionally, patients with MI treated with OND at the early stage had lower SOFA [4(2-6) vs. 4(2-7)] and SAPS II [35(28-43) vs. 36 (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)] during ICU stay compared with those not.…”

Section: Association Between Early Ond Treatment and Clinical Outcome...mentioning

confidence: 99%

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Effects of ondansetron treatment on outcomes of critically ill patients with myocardial infarction partly through its anti-inflammatory activity

Boshen¹,

Yuankang²,

Taixi³

et al. 2023

Int. J. Med. Sci.

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Background: Patients with myocardial infarction (MI) in intensive care units (ICU) are at high risk of death. Whether treatment with ondansetron (OND) at an early stage plays a protective role in critically ill patients with MI and its underlying mechanism remains unclear. Methods: A total of 4486 patients with MI were enrolled in the study cohort from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and divided into OND-medication groups or not. Propensity score matching (PSM) and regression analysis were performed to investigate the effect of OND on patients, accompanied by sensitivity analysis to evaluate the robustness of the results. Integrated with causal mediation analysis (CMA), we investigated the potential causal pathway mediated by the palate-to-lymphocyte ratio (PLR) between early OND treatment and clinical outcomes. Results: Among patients with MI, 976 of them were treated with OND at the early stage while 3510 patients were not. The all-cause in-hospital mortality rate was significantly lower in the OND-medication group (5.6% vs 7.7%), accompanied by lower 28-day mortality (7.8% vs 11.3%) and 90-day mortality (9.2% vs 13.1%) rates. PSM analysis further confirmed the results for in-hospital mortality (5.7% vs 8.0%), 28-day mortality (7.8% vs 10.8%), and 90-day mortality (9.2% vs 12.5%). After adjusting for confounders, multivariate logistic regression analysis revealed that OND was associated with decreased in-hospital mortality (OR = 0.67, 95% CI: 0.49-0.91), and Cox regression confirmed the results for 28-day mortality and 90-day mortality with HR = 0.71 and 0.73, respectively. Most importantly, CMA demonstrated that the protective effect of OND on patients with MI was mediated by its anti-inflammatory effect through the regulation of PLR. Conclusion: Early use of OND in critically ill patients with MI may exert protective effects by reducing in-hospital mortality and 28-and 90-day mortality. The beneficial effects of OND on these patients were exerted through anti-inflammatory effects, at least in part.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Outcomes After Psmmentioning

confidence: 96%

Section: Association Between Early Ond Treatment and Clinical Outcome...mentioning

confidence: 99%

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Effects of ondansetron treatment on outcomes of critically ill patients with myocardial infarction partly through its anti-inflammatory activity

Boshen¹,

Yuankang²,

Taixi³

et al. 2023

Int. J. Med. Sci.

View full text Add to dashboard Cite

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“…In practice, postoperative TIMI blood flow was a separate predictor of in-hospital mortality in SARS-CoV-2-positive patients, consistent with previous reports on STEMI patients. [ 38 ] The interaction between inflammation, thrombogenic factors, and others may influence the efficacy of refusion in the coronary artery of STEMI patients, subsequently affecting the outcomes of patients.…”

Section: Discussionmentioning

confidence: 99%

Differences in door-to-balloon time and outcomes in SARS-CoV-2-positive ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: A systematic review and meta-analysis

Bao,

Li,

Wang

et al. 2023

Medicine

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Background: The coronavirus disease 2019 infection has significantly impacted the world and placed a heavy strain on the medical system and the public, especially those with cardiovascular diseases. Hoverer, the differences in door-to-balloon time and outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not known too much. Methods: Web of Science, EMBASE, PubMed, Cochrane Library, Wanfang, VIP, and China’s National Knowledge Infrastructure were utilized to perform a systematic literature search until April 30, 2023. We computed the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) to determine the correlation. A random-effects model was used for the meta-analysis if the study had significant heterogeneity. Meanwhile, sensitivity analysis and Trial sequential analysis were also accomplished using Rveman5.4 and trial sequential analysis 0.9.5.10 Beta software, respectively. Results: A total of 5 eligible studies were explored in our meta-analysis, including 307 cases and 1804 controls. By meta-analysis, the pooled data showed that SARS-CoV-2-positive STEMI patients undergoing percutaneous coronary intervention had a longer door-to-balloon time (OR 6.31, 95% CI 0.99, 11.63, P = .02) than the negative subjects. The glycoprotein IIb/IIIa inhibitor use after SARS-CoV-2 infection (OR 2.71, 95% CI 1.53, 4.81, P = .0006) was relatively frequent compared with controls, and the postoperative Thrombolysis in Myocardial Infarction blood flow (OR 0.48, 95% CI 0.34, 0.67, P < .0001) was worse compared that. The in-hospital mortality (OR 5.16, 95% CI 3.53, 7.53, P < .00001) was higher than non-SARS-CoV-2 infection ones. In addition, we also discovered that age, gender (male), hypertension, diabetes mellitus, hyperlipidemia, smoking, previous myocardial infarction, total ischemia time, and thrombus aspiration use did not have a significant association with the development of STEMI patients with SARS-CoV-2. Conclusion: SARS-CoV-2 positivity is significantly associated with longer door-to-balloon time and higher in-hospital mortality in STEMI patients undergoing primary percutaneous coronary intervention.

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Independent Predictors of Mortality in COVID-19 Myocardial Injury: The Role of Troponin Levels, GRACE Score, SOFA Score, and TIMI Score

Cited by 2 publications

References 15 publications

Effects of ondansetron treatment on outcomes of critically ill patients with myocardial infarction partly through its anti-inflammatory activity

Effects of ondansetron treatment on outcomes of critically ill patients with myocardial infarction partly through its anti-inflammatory activity

Differences in door-to-balloon time and outcomes in SARS-CoV-2-positive ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: A systematic review and meta-analysis

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