3.2 Systemic corticosteroids and troponins.
In the whole cohort, 137 patients (25%) were treated with systemic
corticosteroids during the in-hospital stay. Corticosteroid treatment
encompassed methylprednisolone (60%; 20-80 mg/day), betamethasone
(22%; 4-8 mg/day) and prednisone (18%; 25-50 mg/day).
Corticosteroid-treated patients were older and more likely to be former
smokers; moreover, they showed a higher prevalence of COPD and AF, and
belonged to higher severity PSI classes than non-treated ones (Table 2).
Among patients with hs-cTnT>0.014 µg/L (n=318), 102
patients (31%) were treated with systemic corticosteroids. In this
group, corticosteroids-treated patients were older and showed a tendency
to a higher prevalence of COPD compared to non-treated ones (Table 3).
Among patients with elevated troponins, no baseline differences were
found between patients treated or not with corticosteroids (0.033
[0.23-0.064] vs. 0.031 [0.021-0.059] µg/L, respectively]; p
value =0.646). In both groups, hs-cTnT levels significantly increased
between 24 and 72 hours from hospital admission (0.042 [0.025-0.082]
µg/L; p value <0.001 and 0.050 [0.027-0.108] µg/L;
p<0.001, respectively); however, the increase in hs-cTnT was
significantly lower in the corticosteroid-treated patients compared to
untreated ones (0.006 [0.00-0.019] vs. 0.012 [0.002-0.040] µg/L;
p value =0.003). At discharge, either group showed similar hs-cTnT
levels. A MANOVA analysis confirmed an effect of corticosteroids on
hs-cTnT, also after adjusting for age, coronary heart disease, heart
failure and COPD (F=4.1; p=0.021) (Figure 2). Among patients with
hs-cTnT ≤0.014, no significant differences in hs-cTnT levels were found
between patients treated or not with corticosteroids, during the
in-hospital stay and at discharge (not shown).