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. 2020 Jul 8;76(10):1244–1258. doi: 10.1016/j.jacc.2020.06.068

Table 2.

Potential Advantages and Disadvantages of Systematic Cardiac Troponin Measurement in Patients With COVID-19

Potential Advantages Potential Disadvantages
  • Detection of myocardial injury.

  • Absence of a clear actionable response to such elevations.

  • Identification of patients at higher risk for adverse cardiovascular outcomes that may warrant further evaluation, e.g., those with marked cTn increases and/or large deltas.

  • Potential unnecessary increased in downstream testing and consultations unless the principles for using cTn measurements are understood.

  • Improved prognostication as cTn facilitates the detection of patients at risk for arrhythmias, ARDS, and death.

  • Potential increases in infection exposure if cTn increases lead to downstream testing that exposes health care personnel to COVID-19–positive patients.

  • Improved resource utilization as those with very low hs-cTn concentrations may require less-intensive care and/or evaluation compared with those with marked increases/deltas in whom more aggressive care, monitoring, and/or evaluation may be needed.

  • Potential inappropriate use of acute coronary syndrome therapies/strategies in patients unlikely to have atherothrombosis.

  • Facilitate the understanding of cardiac involvement and myocardial injury phenotypes/stages in patients with COVID-19.

  • Based on the presence/absence of myocardial injury that portends a higher risk for malignant arrhythmias, inform the use of agents that might have effects on the QTc interval.

ARDS = acute respiratory distress syndrome; other abbreviations as in Table 1.