Association of atherogenic indices with myocardial damage and mortality in COVID-19

Abstract

Background Lipoproteins in cell membranes are related to membrane stability and play a role against microorganisms. Patients with COVID-19 often experience myocyte membrane damage. Objective This study aimed to search the relationship of atherogenic indices with myocardial damage and mortality in COVID-19. Methods This was an observational, single-center, retrospective study. The study population was grouped according to in-hospital mortality. C-reactive protein (CRP), CRP to albumin ratio (CAR), monocyte to high density lipoprotein cholesterol ratio (MHR), levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol (LDLc) and cardiac troponin I (cTnI) were recorded. Atherogenic indices (plasma atherogenic index [AIP], atherogenic coefficient [AC], Castelli’s risk indices I and II [CRI I and II], triglyceride to HDLc ratio (THR) were calculated. Results A total of 783 patients were included. The mortality rate was 15.45% (n = 121). The median age of non-survivor group (NSG) was higher than survivor group (SG) [66.0 years (Q1 –Q3: 55.0–77.5) vs 54.0 years (Q1 –Q3: 43.0–63.0)] (p < 0.001). Study parameters which were measured significantly higher in the NSG were CRP, cTnI, triglyceride, CRI-I, CRI-II, AC, AIP, ferritin, CAR, MHR and THR. LDLc, HDLc, TC and albumin were significantly lower in NSG (p<0.001). Conclusion THR is positively correlated with myocardial damage and strongly predicts in-hospital mortality in COVID-19.