Journal of Advanced Biomedical Sciences

en سطح سرمی LDH، CPK و تروپونین در بیماران قلبی با و بدون کووید-19: یک مطالعه گذشته‌نگر Serum Lactate Dehydrogenase, Creatinine Phosphokinase, and Troponin Levels Among Cardiac Patients with Coronavirus Disease 2019: A Retrospective Study قلب وعروق Cardiology پژوهشي Research <div style="text-align: justify;">Background & Objectives:  Coronavirus disease 2019 (COVID-19) can cause myocardial injury and thereby worsen clinical outcomes in patients with preexisting cardiac disease. This study assessed the association between admission serum lactate dehydrogenase (LDH), creatine phosphokinase (CPK), and troponin levels and clinical outcomes among hospitalized cardiac patients with and without PCR-confirmed COVID-19. Materials & Methods: In this retrospective comparative study, we analyzed 200 consecutive cardiac patients admitted in Zabol, Iran, between March 2019 and March 2020. One-hundred patients had PCR-confirmed COVID-19 and 100 did not. We compared demographic characteristics, admission blood pressure, admission serum LDH, CPK, and troponin levels, baseline left ventricular ejection fraction (EF), and length of hospital stay between groups. Multivariable logistic regression was used to identify independent predictors of in-hospital mortality. Results: Compared with non-COVID-19 cardiac patients, those with COVID-19 exhibited higher mean systolic blood pressure (166.96 versus 143.08 mmHg; p < 0.001), higher mean diastolic blood pressure (110.55 versus 91.35 mmHg; p < 0.001), and higher mean levels of CPK (363.06 versus 270.99 U/L; p < 0.001) and LDH (570.69 versus 384.43 U/L; p < 0.001). Troponin positivity was more frequent among COVID-19 patients (71% versus 41%; p < 0.001). An EF below 35% occurred more often in the COVID-19 cohort (54% versus 20%; p = 0.048). In multivariable analysis, independent predictors of in-hospital mortality were COVID-19 status (adjusted odds ratio [aOR] 2.42; 95% confidence interval [CI], 1.28–4.56), troponin positivity (aOR 3.15; 95% CI, 1.63–6.08), and EF < 35% (aOR 2.89; 95% CI, 1.41–5.91). After adjustment for covariates, neither admission CPK nor LDH remained statistically significant predictors of mortality. Conclusion: Troponin positivity and reduced left ventricular ejection fraction are robust independent predictors of mortality among hospitalized cardiac patients, particularly in the context of COVID-19. Although CPK and LDH are frequently elevated in patients with COVID-19, these markers may predominantly reflect nonspecific tissue injury rather than myocardial-specific damage. Early assessment of troponin and EF on admission can facilitate risk stratification and inform clinical management in this high-risk population.  </div> COVID-19, Troponin, Lactate Dehydrogenase (LDH), Creatine Phosphokinase (CPK), Cardiac Biomarkers 337 347 http://jabs.fums.ac.ir/browse.php?a_code=A-10-3221-3&slc_lang=en&sid=1 Javad Poursamimi جواد پورصمیمی javadpoursamimi@gmail.com 100319475328460030233 100319475328460030233 Yes Department of Immunology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran گروه ایمونولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی زابل، زابل، ایران Babak Barmaki بابک برمکی barmaki.b@yahoo.com 100319475328460030234 100319475328460030234 No Department of Physiology, School of Medicine, Zabol University of Medical Sciences, Zabol گروه فیزیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی زابل، زابل Hamid Reza Ghaffari حمیدرضا غفاری hamidghaffary@yahoo.com 100319475328460030235 100319475328460030235 No Department of Anatomical Sciences, Faculty of Medicine, Zabol University of Medical Sciences, Zabol گروه علوم تشریح، دانشکده پزشکی، دانشگاه علوم پزشکی زابل، زابل Yahya Ehsanollahi یحیی احسان الهی dr.y.ehsanollahiiii@gmail.com 100319475328460030236 100319475328460030236 No Assistant Professor, Department of Surgery, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran استادیار، گروه جراحی، دانشکده پزشکی، دانشگاه علوم پزشکی زابل، زابل، ایران